Provider Demographics
NPI:1467570150
Name:GRISKIE, CHRISTIN NOEL (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:NOEL
Last Name:GRISKIE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 HARBOR HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:CENTERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11721-1621
Mailing Address - Country:US
Mailing Address - Phone:631-757-0347
Mailing Address - Fax:
Practice Address - Street 1:34 HARBOR HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:CENTERPORT
Practice Address - State:NY
Practice Address - Zip Code:11721-1621
Practice Address - Country:US
Practice Address - Phone:631-757-0347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYL1599920225100000X
FLPT 23812225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist