Provider Demographics
NPI:1831266428
Name:GRUSKY, HAROLD E (DC)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:E
Last Name:GRUSKY
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 1:3836 W HILLSBORO BLVD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-9413
Mailing Address - Country:US
Mailing Address - Phone:954-421-2355
Mailing Address - Fax:954-421-6455
Practice Address - Street 1:3836 W HILLSBORO BLVD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-9413
Practice Address - Country:US
Practice Address - Phone:954-421-2355
Practice Address - Fax:954-421-6455
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6453111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU28890Medicare UPIN
FL22734Medicare ID - Type Unspecified