Individual
MS. MIA GROTTOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
512 E 82ND ST, APT. 4D, NEW YORK, NY 10028-7111
(609) 204-4711
Mailing address
512 E 82ND ST, APT. 4D, NEW YORK, NY 10028-7111
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
—
—
Other
Enumeration date
12/05/2012
Last updated
12/05/2012
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