Provider Demographics
NPI:1295244184
Name:GREY GENETICS, LLC
Entity type:Organization
Organization Name:GREY GENETICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CGC
Authorized Official - Phone:516-900-4363
Mailing Address - Street 1:41 CLARKSON AVE APT 2E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-1947
Mailing Address - Country:US
Mailing Address - Phone:516-900-4363
Mailing Address - Fax:
Practice Address - Street 1:223 BEDFORD AVE STE 1137
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-4171
Practice Address - Country:US
Practice Address - Phone:516-900-4363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-24
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170300000XOther Service ProvidersGenetic Counselor, MSGroup - Single Specialty