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General NPI Number Information
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NPI Number | 1871699686
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Entity Type | Individual
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Provider Name | ROBERT H GROZALIS JR. MS
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Gender | Male
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 680 HEACOCK RD SUITE 203
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City | YARDLEY
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State | PA
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Zip | 19067
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Country | US
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Telephone | 215-321-2337
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Fax | 215-321-2339
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Provider Business Mailing Address
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Address Line | 680 HEACOCK RD SUITE 203
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City | YARDLEY
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State | PA
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Zip | 19067
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Country | US
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Telephone | 215-321-2337
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Fax | 215-321-2339
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AT005886
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License Number State | PA
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Legacy Identifiers
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Identifier #1
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Identifier Code | 2342258000
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Identifier Type | OTHER
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Identifier State | PA
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Identifier Issuer | INDEPENDENCE BC
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Identifier #2
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Identifier Code | 3573618
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Identifier Type | OTHER
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Identifier State | PA
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Identifier Issuer | AETNA
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Identifier #3
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Identifier Code | 1011559410001
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Identifier Type | MEDICAID
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Identifier State | PA
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Identifier Issuer |
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 1011559410001
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Identifier Type | MEDICAID
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Identifier State | PA
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Identifier Issuer |
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Identifier #2
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Identifier Code | 2342258000
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Identifier Type | OTHER
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Identifier State | PA
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Identifier Issuer | INDEPENDENCE BC
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Identifier #3
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Identifier Code | 3573618
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Identifier Type | OTHER
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Identifier State | PA
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Identifier Issuer | AETNA
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