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NPI Code Detail

MEDICARE: DEBBIE GRILLOS RN

MEDICARE:   DEBBIE  GRILLOS  RN
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
1163W00000XRegistered Nurse482387NY

General Provider Information

NPI Number : 1972877934
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBBIE GRILLOS RN
Provider Business Mailing Address
First Line : 3117 AVENUE W
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-5918
Country : US
Telephone Number : 718-648-8804
Fax Number : 718-934-0244
Provider Business Practice Location Address
First Line : 3117 AVENUE W
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-5918
Country : US
Telephone Number : 718-648-8804
Fax Number : 718-934-0244
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2012
Last Update Date : 03/08/2012

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