Provider Demographics
NPI:1740880996
Name:GRIGORE, ROBERT A (BCBA)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:GRIGORE
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 ROBIN CIR
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-1200
Mailing Address - Country:US
Mailing Address - Phone:617-407-3666
Mailing Address - Fax:
Practice Address - Street 1:44 DIAUTO DR
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-4536
Practice Address - Country:US
Practice Address - Phone:617-407-3666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3026103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst