Provider Demographics
NPI:1427296680
Name:GROSS, DANIELLE A
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:A
Last Name:GROSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 NFU
Mailing Address - Street 2:UNIVERSITY DR C
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15240
Mailing Address - Country:US
Mailing Address - Phone:412-360-6726
Mailing Address - Fax:412-360-3560
Practice Address - Street 1:120 NFU
Practice Address - Street 2:UNIVERSITY DR C
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240
Practice Address - Country:US
Practice Address - Phone:412-360-6726
Practice Address - Fax:412-360-3560
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003854133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered