Individual provider Active NPI

Leah Grossman

  • Specialist
  • Bala Cynwyd, PA
National Provider Identifier
1457612400
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
OC012308 Issued in PA
Practice address
10 Montgomery Ave
Aptartment A2
Bala Cynwyd, PA 19004-2949
Phone
(248) 281-5476
NPI assigned
Jun 6, 2012
Last updated
Jun 6, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X OC012308 PA Primary

Addresses

Primary practice location

10 Montgomery Ave
Aptartment A2
Bala Cynwyd, PA 19004-2949

Mailing address

10 Montgomery Ave
Aptartment A2
Bala Cynwyd, PA 19004-2949
Phone (248) 281-5476

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OC012308PAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1457612400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MONTGOMERY AVE",
            "address_2": "APTARTMENT A2",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190042949",
            "telephone_number": "248-281-5476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MONTGOMERY AVE",
            "address_2": "APTARTMENT A2",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190042949",
            "telephone_number": "248-281-5476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "LEAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "OC012308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; 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.