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General NPI Number Information
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NPI Number | 1154991412
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Entity Type | Individual
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Provider Name | ZACHARY GRIN PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 06/29/2021
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Last Update Date | 07/05/2023
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Provider Practice Location Address
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Address Line | 16 MADISON SQ W FL 11
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City | NEW YORK
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State | NY
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Zip | 10010-0061
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Country | US
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Telephone | 646-397-2416
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Fax | 332-334-2990
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Provider Business Mailing Address
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Address Line | 175 E 96TH ST APT 23Q
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City | NEW YORK
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State | NY
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Zip | 10128-6212
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Country | US
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Telephone | 219-381-9518
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA02007200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 047350
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License Number State | NY
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