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General NPI Number Information
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NPI Number | 1265947139
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Entity Type | Individual
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Provider Name | KIMBERLY ANN GRONSKI PT
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Gender | Female
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Dates
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Enumeration Date | 12/13/2017
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Last Update Date | 10/15/2018
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Provider Practice Location Address
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Address Line | 143 SOUND BEACH AVE
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City | OLD GREENWICH
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State | CT
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Zip | 06870-1736
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Country | US
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Telephone | 203-817-0196
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Fax | 203-817-0199
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Provider Business Mailing Address
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Address Line | 1377 MOTOR PKWY STE 307
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City | ISLANDIA
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State | NY
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Zip | 11749-5258
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Country | US
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Telephone | 631-580-5200
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Fax | 631-580-5222
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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 | 11696
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License Number State | CT
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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 | 041862
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT026489
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTL.0015603
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License Number State | CO
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 27177
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License Number State | MD
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Taxonomy #6
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | WY
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