Provider Demographics
NPI:1801577366
Name:GROZOZSKI-TORRES, JULISSA (NYCPS/ CRPA)
Entity type:Individual
Prefix:
First Name:JULISSA
Middle Name:
Last Name:GROZOZSKI-TORRES
Suffix:
Gender:F
Credentials:NYCPS/ CRPA
Other - Prefix:
Other - First Name:JULISSA
Other - Middle Name:
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NYCPS/ CRPA
Mailing Address - Street 1:42-09 28TH STREET
Mailing Address - Street 2:WS 21-133
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101
Mailing Address - Country:US
Mailing Address - Phone:646-856-6752
Mailing Address - Fax:
Practice Address - Street 1:42-09 28TH STREET
Practice Address - Street 2:WS 21-133
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101
Practice Address - Country:US
Practice Address - Phone:646-856-6752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCRPA-5835175T00000X
NYNYCPS-2344175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist