Doctor Name: | JOAN M. GRZYBOWSKI |
NPI Number: | 1285675256 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DO |
License Number: | OS006483L |
Business Practice Address: | 4190 City Ave Philadelphia, PA - 191311626 |
Business Phone Number: | 2158716380 |
Business Fax Number: | 2158716381 |
Mailing Address: | 4190 City Ave, PHILADELPHIA |
State: | PA |
Postal Code: | 191311626 |
Phone Number: | 2158716380 |
Fax Number: | 2158716381 |
NPI Enumeration Date: | 06/09/2006 |
NPI Last Update Date: | 02/23/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | OS006483L |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |