Provider Demographics
NPI:1831462399
Name:GRZYBICKI, JOSEPH (LMT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:GRZYBICKI
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2938 COLUMBIA AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-7011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2938 COLUMBIA AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-7011
Practice Address - Country:US
Practice Address - Phone:717-201-7868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG002123174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist