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General NPI Number Information
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NPI Number | 1881726875
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Entity Type | Individual
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Provider Name | LYNNE MARIE GRAMBERG PT, ATC, OCS
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Gender | Female
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 5800 RIDGE AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19128-1737
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Country | US
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Telephone | 215-487-4718
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Fax | 215-487-4328
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Provider Business Mailing Address
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Address Line | 7920 CADILLAC LN
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City | PHILADELPHIA
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State | PA
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Zip | 19128-1306
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Country | US
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Telephone | 215-487-7811
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Fax | 215-487-4328
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT008258L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RT000128A
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License Number State | PA
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