| Doctor Name: | REBECCA JUDE GRILLO |
| NPI Number: | 1093856833 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.A. |
| License Number: | 001359 |
| Business Practice Address: | 52 Washington Ave Suite 4 North Haven, CT - 064731724 |
| Business Phone Number: | 2036722800 |
| Business Fax Number: | 2036722801 |
| Mailing Address: | 52 Washington Ave, Suite 4 NORTH HAVEN |
| State: | CT |
| Postal Code: | 064731724 |
| Phone Number: | 2036722800 |
| Fax Number: | 2036722801 |
| NPI Enumeration Date: | 02/12/2007 |
| NPI Last Update Date: | 08/02/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 001359 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |