MEDICARE: DR. MARISSA NICOLE GRILLO PHARMD

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	183500000X	Pharmacist	PH200004931	DC

General Provider Information

NPI Number	:	1578251187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARISSA NICOLE GRILLO PHARMD

Provider Business Mailing Address
First Line	:	30 PROSPECT AVE
Second Line	:
City	:	HACKENSACK
State	:	NJ
Zip	:	07601-1915
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 MICHIGAN AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20010-2916
Country	:	US
Telephone Number	:	888-884-2327
Fax Number	:

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

Provider Enumeration Date	:	05/01/2023
Last Update Date	:	02/23/2026

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