Provider Demographics
NPI:1558804013
Name:GRILL, SARAH M (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:M
Last Name:GRILL
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 W TREMONT AVE
Mailing Address - Street 2:P186X@306
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-5400
Mailing Address - Country:US
Mailing Address - Phone:718-716-5796
Mailing Address - Fax:718-299-0727
Practice Address - Street 1:40 W TREMONT AVE
Practice Address - Street 2:P186X@306
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-5400
Practice Address - Country:US
Practice Address - Phone:718-716-5796
Practice Address - Fax:718-299-0727
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025484-1235Z00000X
NJ41YS00860700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist