Provider Demographics
NPI:1700641941
Name:GRYGIEL, OLGA (PAC)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:GRYGIEL
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 ST LUKES DR
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1696
Mailing Address - Country:US
Mailing Address - Phone:267-985-1100
Mailing Address - Fax:267-985-1125
Practice Address - Street 1:3000 ST LUKES DR
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1696
Practice Address - Country:US
Practice Address - Phone:267-985-1100
Practice Address - Fax:267-985-1125
Is Sole Proprietor?:No
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA006806363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant