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General NPI Number Information
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NPI Number | 1922452267
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Entity Type | Organization
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Legal Business Name | YANA GRIGOREFF MD
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Dates
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Enumeration Date | 04/22/2016
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Last Update Date | 04/22/2016
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Provider Practice Location Address
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Address Line | 535 GRADYVILLE RD
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073-2812
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Country | US
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Telephone | 409-256-4537
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Fax |
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Provider Business Mailing Address
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Address Line | 2201 PENNSYLVANIA AVE APT 319
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City | PHILADELPHIA
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State | PA
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Zip | 19130-3513
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Country | US
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Telephone | 409-256-4537
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YANA GRIGOREFF
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Credential |
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Telephone | 409-256-4537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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