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NPI Code Detail

MEDICARE: MR. ANDREW GROMELSKI

MEDICARE: MR. ANDREW GROMELSKI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1093106973
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANDREW GROMELSKI
Provider Business Mailing Address
First Line : 243 NEW ST
Second Line :
City : DURYEA
State : PA
Zip : 18642-1424
Country : US
Telephone Number : 570-212-2406
Fax Number :
Provider Business Practice Location Address
First Line : 185 S MOUNTAIN BLVD
Second Line :
City : MOUNTAIN TOP
State : PA
Zip : 18707-1921
Country : US
Telephone Number : 570-474-6377
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2015
Last Update Date : 02/12/2015

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Directions to “ MR. ANDREW GROMELSKI ” Practice Location

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