Provider Demographics
NPI:1962561985
Name:GROSSO, CELESTE M (MD)
Entity type:Individual
Prefix:DR
First Name:CELESTE
Middle Name:M
Last Name:GROSSO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:47 W MARKET ST STE 106
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1413
Mailing Address - Country:US
Mailing Address - Phone:845-516-5007
Mailing Address - Fax:845-516-5009
Practice Address - Street 1:47 W MARKET ST STE 106
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1413
Practice Address - Country:US
Practice Address - Phone:845-516-5007
Practice Address - Fax:845-516-5009
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2264562084P0804X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No208000000XAllopathic & Osteopathic PhysiciansPediatrics