Grosso Family Medicine Pc | |
5927 State Route 981 Suite 8 Latrobe PA 15650-2687 | |
(724) 879-8739 | |
(724) 879-4292 |
Full Name | Grosso Family Medicine Pc |
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Speciality | Family Medicine |
Location | 5927 State Route 981, Latrobe, Pennsylvania |
Authorized Official Name and Position | Kevin J Grosso (PRESIDENT) |
Authorized Official Contact | 7248798739 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Grosso Family Medicine Pc 5927 State Route 981 Suite 8 Latrobe PA 15650-2687 Ph: (724) 879-8739 | Grosso Family Medicine Pc 5927 State Route 981 Suite 8 Latrobe PA 15650-2687 Ph: (724) 879-8739 |
NPI Number | 1518266675 |
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Provider Enumeration Date | 03/15/2011 |
Last Update Date | 12/19/2014 |
Medicare PECOS PAC ID | 4789869678 |
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Medicare Enrollment ID | O20110419000266 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518266675 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | OS013058 (Pennsylvania) | Primary |
Provider Name | Kevin John Grosso |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1578579009 PECOS PAC ID: 5991702706 Enrollment ID: I20061108000270 |
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