Provider Demographics
NPI:1679010680
Name:GRIGOLI, FRANK
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:GRIGOLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MINERAL SPRING RD
Mailing Address - Street 2:
Mailing Address - City:MILLSTONE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08510-8754
Mailing Address - Country:US
Mailing Address - Phone:917-442-0125
Mailing Address - Fax:
Practice Address - Street 1:8 MINERAL SPRING RD
Practice Address - Street 2:
Practice Address - City:MILLSTONE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08510-8754
Practice Address - Country:US
Practice Address - Phone:917-442-0125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-28
Last Update Date:2017-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJG74162678202772225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter