Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 020713-1 | NY |
NPI | 1194352955 |
---|---|
Provider Name | Krista Grzebinski |
First Address | Buffalo, NY 14209-1080 |
Second Address | Buffalo, NY 14217-1304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2020 |
Last Update Date | 23/03/2020 |