Kerry Kathleen Grohman, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

015340-1 Issued in NY

Practice address

3495 Bailey Ave
VA-Wnyhs, 116B
Buffalo, NY 14215-1129

Phone

(716) 833-3827

Fax

(716) 833-9710

NPI assigned

Oct 4, 2006

Last updated

Apr 29, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1083709943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 WASHINGTON HWY",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142264648",
            "telephone_number": "716-833-3827",
            "fax_number": "716-833-9710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3495 BAILEY AVE",
            "address_2": "VA-WNYHS, 116B",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151129",
            "telephone_number": "716-833-3827",
            "fax_number": "716-833-9710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROHMAN",
        "first_name": "KERRY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "015340-1",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NY",
            "license": "015340-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02407041",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Lynn Griner, PA-C
• Thomas Donald Grinnell Jr., LCSW
• John Batista Grippi, M.D.
• Kim S Griswold, MD
• Karolyn P Groff
• Lisa Gromlovits
• Heather Gronkowski
• Kimberley Grose
• Mary Grose
• Gary Grosner, M.D.

• Clinical Neuropsychologist in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Clinical Neuropsychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.