Provider Demographics
NPI:1932320330
Name:GRIGORIOU L.L.C.
Entity Type:Organization
Organization Name:GRIGORIOU L.L.C.
Other - Org Name:ADVANCED CHIROPRACTIC OF RIDGEWOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIGORIOU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-873-4644
Mailing Address - Street 1:128 KINDERKAMACK RD
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07656-1353
Mailing Address - Country:US
Mailing Address - Phone:201-505-9702
Mailing Address - Fax:201-505-9701
Practice Address - Street 1:128 KINDERKAMACK RD
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07656-1353
Practice Address - Country:US
Practice Address - Phone:201-505-9702
Practice Address - Fax:201-505-9701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00611600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty