MEDICARE: DR. JOSEPH L GRISAFI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	MD427860	PA
2	2086S0129X	Vascular Surgery Physician	MD427860	PA

General Provider Information

NPI Number	:	1194939736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH L GRISAFI M.D.

Provider Business Mailing Address
First Line	:	2583 COLD SPRING RD
Second Line	:
City	:	LANSDALE
State	:	PA
Zip	:	19446-6065
Country	:	US
Telephone Number	:	484-744-1063
Fax Number	:

Provider Business Practice Location Address
First Line	:	2924 SWEDE RD
Second Line	:
City	:	EAST NORRITON
State	:	PA
Zip	:	19401-1336
Country	:	US
Telephone Number	:	484-744-1063
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	07/22/2015

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