Provider Demographics
NPI:1326824590
Name:GRZYBOWSKI, JILLIAN (LCAT, ATR-BC)
Entity Type:Individual
Prefix:MS
First Name:JILLIAN
Middle Name:
Last Name:GRZYBOWSKI
Suffix:
Gender:F
Credentials:LCAT, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 E 88TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-4909
Mailing Address - Country:US
Mailing Address - Phone:646-559-6674
Mailing Address - Fax:646-365-0585
Practice Address - Street 1:316 E 88TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-4909
Practice Address - Country:US
Practice Address - Phone:646-559-6674
Practice Address - Fax:646-365-0585
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002858-01221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist