Provider Demographics
NPI:1174856991
Name:GRUCHALSKA, BARBARA (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:GRUCHALSKA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:671 ROUTE 6
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-1638
Mailing Address - Country:US
Mailing Address - Phone:845-286-0600
Mailing Address - Fax:
Practice Address - Street 1:671 ROUTE 6
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541
Practice Address - Country:US
Practice Address - Phone:845-286-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-11
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05663311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice