Healthcare Provider Details

I. General information

NPI: 1174679005
Provider Name (Legal Business Name): JO-ANNE GRABOWSKI PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 COLUMBUS ST
CHEEKTOWAGA NY
14227-1251
US

IV. Provider business mailing address

525 WASHINGTON ST
BUFFALO NY
14203-1711
US

V. Phone/Fax

Practice location:
  • Phone: 716-894-2743
  • Fax: 716-896-6394
Mailing address:
  • Phone: 716-856-4494
  • Fax: 716-842-1277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number00012694
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: