Provider Demographics
NPI:1942750005
Name:GRABOWSKI, CAITLYN MARIE (ATC)
Entity Type:Individual
Prefix:MRS
First Name:CAITLYN
Middle Name:MARIE
Last Name:GRABOWSKI
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:MISS
Other - First Name:CAITLYN
Other - Middle Name:
Other - Last Name:KUBIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:56 KINGSTON DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-4952
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 LAKEWOOD AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-2600
Practice Address - Country:US
Practice Address - Phone:732-987-2687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-12
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT002250002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer