Andrey Gritsman, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

25MA06026100 Issued in NJ

Practice address

223 North Van Dien Avenue
Valley Hospital
Ridgewood, NJ 07450

Phone

(201) 447-8242

Fax

(201) 447-8657

NPI assigned

Jan 8, 2007

Sex

Male

Sole proprietor

No

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 Medicine

State licenses

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1134277601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 266",
            "city": "LEWISBERRY",
            "state": "PA",
            "postal_code": "173390266",
            "telephone_number": "800-223-0925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 NORTH VAN DIEN AVENUE",
            "address_2": "VALLEY HOSPITAL",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "07450",
            "telephone_number": "201-447-8242",
            "fax_number": "201-447-8657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRITSMAN",
        "first_name": "ANDREY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "60261",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "25MA06026100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6067000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marni Leigh Greenwald, LCAT, BC
• Robert Greenwald
• Amrit Grewal, MD
• Carl T Grimm, LCSW
• Jessica Leigh Grimm, DPT
• Rita Grogan, MD
• Theresa Kathleen Grueter, LCSW
• Jordan Gruschow
• Lisa Marie Gudicello, M.D.
• Guy Guerriero, D.C.

• Anatomic Pathology & Clinical Pathology Physician in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Anatomic Pathology & Clinical Pathology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; 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.