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General NPI Number Information
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NPI Number | 1285675256
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Entity Type | Individual
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Provider Name | JOAN M. GRZYBOWSKI DO
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Gender | Female
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 08/06/2019
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Provider Practice Location Address
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Address Line | 4190 CITY AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19131-1626
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Country | US
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Telephone | 215-871-6380
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Fax | 215-871-6381
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Provider Business Mailing Address
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Address Line | PO BOX 824112
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City | PHILADELPHIA
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State | PA
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Zip | 19182-2547
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Country | US
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Telephone | 215-871-6380
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Fax | 215-871-6381
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | OS006483L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS006483L
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License Number State | PA
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