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General NPI Number Information
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NPI Number | 1740603893
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Entity Type | Individual
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Provider Name | MR. WAYNE GRIER
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Gender | Male
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Dates
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Enumeration Date | 01/27/2014
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Last Update Date | 01/27/2014
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Provider Practice Location Address
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Address Line | 107 FENN RD
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City | NEWINGTON
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State | CT
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Zip | 06111-2250
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Country | US
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Telephone | 860-404-5775
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Fax |
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Provider Business Mailing Address
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Address Line | 159 BELMONT ST 159 BELMONT STREET
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City | NEW BRITAIN
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State | CT
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Zip | 06053-3507
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Country | US
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Telephone | 860-878-0784
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | NA91286132
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License Number State | CT
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