Individual provider Active NPI

Leonard Grossman, M.D.

  • Obstetrics & Gynecology Physician
  • Mount Holly, NJ
National Provider Identifier
1457388563
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25MA03624700 Issued in NJ
Practice address
120 Madison Ave
Suite B
Mount Holly, NJ 08060-2055
Phone
(609) 261-4925
Fax
(609) 261-9362
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 25MA03624700 NJ Primary

Addresses

Primary practice location

120 Madison Ave
Suite B
Mount Holly, NJ 08060-2055

Mailing address

120 Madison Ave
Suite B
Mount Holly, NJ 08060-2055
Phone (609) 261-4925

Other identifiers 1

IdentifierTypeStateIssuer
0016730OtherNJAETNA HMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457388563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MADISON AVE",
            "address_2": "SUITE B",
            "city": "MOUNT HOLLY",
            "state": "NJ",
            "postal_code": "080602055",
            "telephone_number": "609-261-4925",
            "fax_number": "609-261-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MADISON AVE",
            "address_2": "SUITE B",
            "city": "MOUNT HOLLY",
            "state": "NJ",
            "postal_code": "080602055",
            "telephone_number": "609-261-4925",
            "fax_number": "609-261-9362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "LEONARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA03624700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "0016730",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Holly, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.