Provider Demographics
NPI:1679501555
Name:GRABSKI, BEVERLY LYNN (DC)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:LYNN
Last Name:GRABSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1639 MIDLAND BEAVER RD
Mailing Address - Street 2:
Mailing Address - City:INDUSTRY
Mailing Address - State:PA
Mailing Address - Zip Code:15052-1405
Mailing Address - Country:US
Mailing Address - Phone:724-643-9633
Mailing Address - Fax:724-643-9554
Practice Address - Street 1:1639 MIDLAND BEAVER RD
Practice Address - Street 2:
Practice Address - City:INDUSTRY
Practice Address - State:PA
Practice Address - Zip Code:15052-1405
Practice Address - Country:US
Practice Address - Phone:724-643-9633
Practice Address - Fax:724-643-9554
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007788-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0093330001OtherCIGNA #
PABG1027404OtherASHN #
PAGR915320OtherBCBS #
PA2618897OtherAETNA #
PA7731261OtherAETNA #
PAGR915320OtherBCBS #
PAU83159Medicare UPIN