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NPI Code Detail

MEDICARE: STEPHANIE GRZYMSKI PT

MEDICARE: STEPHANIE GRZYMSKI PT
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
1225100000XPhysical TherapistDAPT000376PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11629664OTHERPABLUE SHIELD

General Provider Information

NPI Number : 1528032026
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE GRZYMSKI PT
Provider Business Mailing Address
First Line : W RIDGE ST
Second Line :
City : NANTICOKE
State : PA
Zip : 18634
Country : US
Telephone Number : 570-466-9759
Fax Number :
Provider Business Practice Location Address
First Line : 354 MAIN ST
Second Line :
City : FOREST CITY
State : PA
Zip : 18421-1418
Country : US
Telephone Number : 570-785-2018
Fax Number : 570-785-2061
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2006
Last Update Date : 12/04/2024

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Directions to “ STEPHANIE GRZYMSKI PT” Practice Location

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