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General NPI Number Information
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NPI Number | 1467641209
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Entity Type | Organization
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Legal Business Name | GRZEGORZ WOLSKI PT PC
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 07/01/2015
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Provider Practice Location Address
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Address Line | 7002 FRESH POND RD
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City | RIDGEWOOD
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State | NY
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Zip | 11385-5902
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Country | US
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Telephone | 718-381-3373
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Fax | 718-381-3378
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Provider Business Mailing Address
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Address Line | 11115 75TH AVE SUITE 40
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City | FOREST HILLS
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State | NY
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Zip | 11375-6327
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Country | US
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Telephone | 917-723-5824
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Fax | 718-575-0520
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Authorized Official
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Title or Position | PRESIDENT
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Name | GRZEGORZ WOLSKI
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Credential | PT
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Telephone | 917-723-5824
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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 | 023168
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License Number State | NY
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