Basic Information
| Provider Information | |||||||||
| NPI: | 1316004088 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GRIEGER | ||||||||
| FirstName: | MEREDITH | ||||||||
| MiddleName: | |||||||||
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| Credential: | P.T. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | KELLY | ||||||||
| OtherFirstName: | MEREDITH | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2900 WESTCHESTER AVE | ||||||||
| Address2: | SUITE 307 | ||||||||
| City: | PURCHASE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105772552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9142497000 | ||||||||
| FaxNumber: | 9142497032 | ||||||||
| Practice Location | |||||||||
| Address1: | 1500 ASTOR AVE | ||||||||
| Address2: | SUITE 1E | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104695900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186520003 | ||||||||
| FaxNumber: | 7186520815 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2007 | ||||||||
| LastUpdateDate: | 02/06/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 024283 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.