Provider Demographics
NPI:1740350701
Name:GREMAUD, PIERRE (DC)
Entity type:Individual
Prefix:DR
First Name:PIERRE
Middle Name:
Last Name:GREMAUD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 1/2 W BUFFALO ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-4132
Mailing Address - Country:US
Mailing Address - Phone:607-277-2570
Mailing Address - Fax:
Practice Address - Street 1:114 1/2 W BUFFALO ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4132
Practice Address - Country:US
Practice Address - Phone:607-277-2570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006347-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor