Provider Demographics
NPI:1427087691
Name:CONO M.GRASSO, M.D.P.C.
Entity type:Organization
Organization Name:CONO M.GRASSO, M.D.P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CONO
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GRASSO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-429-0300
Mailing Address - Street 1:8305 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4104
Mailing Address - Country:US
Mailing Address - Phone:718-429-0300
Mailing Address - Fax:718-899-6338
Practice Address - Street 1:8305 GRAND AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4104
Practice Address - Country:US
Practice Address - Phone:718-429-0300
Practice Address - Fax:718-899-6338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY124324207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00097Medicare ID - Type Unspecified