Provider Demographics
NPI:1013126812
Name:GRILLO, FRANCINE THERESA (LICENSED PRACTICAL N)
Entity Type:Individual
Prefix:MRS
First Name:FRANCINE
Middle Name:THERESA
Last Name:GRILLO
Suffix:
Gender:F
Credentials:LICENSED PRACTICAL N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1085 WARBURTON AVE
Mailing Address - Street 2:#617
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1013
Mailing Address - Country:US
Mailing Address - Phone:914-966-1506
Mailing Address - Fax:
Practice Address - Street 1:501 SWANSON DRIVE
Practice Address - Street 2:
Practice Address - City:THORNWOOD
Practice Address - State:NY
Practice Address - Zip Code:10594-1101
Practice Address - Country:US
Practice Address - Phone:914-769-3630
Practice Address - Fax:914-769-3632
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY117687164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02755984Medicaid