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General NPI Number Information
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NPI Number | 1447455076
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Entity Type | Organization
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Legal Business Name | HOWARD GRILL MD AND DAVID GRILL MD
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 121 S OCEAN AVE 1
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City | FREEPORT
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State | NY
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Zip | 11520-4452
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Country | US
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Telephone | 516-379-5005
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Fax | 516-379-9053
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Provider Business Mailing Address
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Address Line | 121 S OCEAN AVE 1
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City | FREEPORT
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State | NY
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Zip | 11520-4452
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Country | US
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Telephone | 516-379-5005
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Fax | 516-379-9053
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Authorized Official
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Title or Position | PARTNER
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Name | HOWARD E GRILL
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Credential | MD
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Telephone | 516-379-5005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 124847
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License Number State | NY
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