Provider Demographics
NPI:1700110293
Name:GRECHKO, NANCY PATRICIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:PATRICIA
Last Name:GRECHKO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:NANCY
Other - Middle Name:PATRICIA
Other - Last Name:DOS SANTOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:12 GRISSOM RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-2219
Mailing Address - Country:US
Mailing Address - Phone:860-758-0757
Mailing Address - Fax:
Practice Address - Street 1:27 HARTFORD TPKE STE 201
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066
Practice Address - Country:US
Practice Address - Phone:860-758-0757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
003471103T00000X
103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist