Provider Demographics
NPI:1700062395
Name:GRADILONE, PETER EDWARD (MSW)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:EDWARD
Last Name:GRADILONE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 PELHAM RD APT 7C
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10805-3108
Mailing Address - Country:US
Mailing Address - Phone:914-235-2382
Mailing Address - Fax:
Practice Address - Street 1:507 FIFTH AVE
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NY
Practice Address - Zip Code:10803-1205
Practice Address - Country:US
Practice Address - Phone:914-738-1728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical