Provider Demographics
NPI:1639470784
Name:GRIDLEY CROSBY, JULIE A (CD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:GRIDLEY CROSBY
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 HAZELWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224-1315
Mailing Address - Country:US
Mailing Address - Phone:315-450-2229
Mailing Address - Fax:
Practice Address - Street 1:900 HAZELWOOD AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13224-1315
Practice Address - Country:US
Practice Address - Phone:315-450-2229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula