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General NPI Number Information
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NPI Number | 1134352875
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Entity Type | Individual
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Provider Name | ERIC JOHN GRISPO OTR/L
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Gender | Male
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Dates
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Enumeration Date | 08/28/2009
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Last Update Date | 06/07/2012
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Provider Practice Location Address
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Address Line | 201 WARREN ST
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City | NEW YORK
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State | NY
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Zip | 10282-1002
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Country | US
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Telephone | 212-571-5659
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Fax |
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Provider Business Mailing Address
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Address Line | 2700 JOHN F KENNEDY BLVD 212
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City | JERSEY CITY
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State | NJ
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Zip | 07306
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Country | US
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Telephone | 718-496-7335
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 010112-1
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License Number State | NY
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