Provider Demographics
NPI:1922134634
Name:GRABLE-ESPOSITO, PHYLLIS GOLDA (MD)
Entity Type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:GOLDA
Last Name:GRABLE-ESPOSITO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PHYLLIS
Other - Middle Name:GOLDA
Other - Last Name:GRABLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:85 SEYMOUR ST STE 800
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-5527
Mailing Address - Country:US
Mailing Address - Phone:860-522-4429
Mailing Address - Fax:860-249-6742
Practice Address - Street 1:85 SEYMOUR ST STE 800
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5527
Practice Address - Country:US
Practice Address - Phone:860-522-4429
Practice Address - Fax:860-249-6742
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2312982084N0008X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine