Provider Demographics
NPI:1710428925
Name:GRITTI, LAYNE A (DO)
Entity Type:Individual
Prefix:DR
First Name:LAYNE
Middle Name:A
Last Name:GRITTI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:LAYNE
Other - Middle Name:A
Other - Last Name:PERKOWITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:480 STEEP ROCK DR
Mailing Address - Street 2:
Mailing Address - City:SAGAMORE HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44067-3212
Mailing Address - Country:US
Mailing Address - Phone:847-502-6206
Mailing Address - Fax:
Practice Address - Street 1:710 JOHNNIE DODDS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3045
Practice Address - Country:US
Practice Address - Phone:843-800-1303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-20
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.0149072084P0800X
SC878942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry