Healthcare Provider Details

I. General information

NPI: 1891612024
Provider Name (Legal Business Name): GABRIELA GRIGGS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 E 160TH ST FL 2
BRONX NY
10456-7898
US

IV. Provider business mailing address

610 WARING AVE APT 3W
BRONX NY
10467-7714
US

V. Phone/Fax

Practice location:
  • Phone: 929-377-5164
  • Fax:
Mailing address:
  • Phone: 929-377-5164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number42063
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: