Individual
MRS. ALEXIS MARIE GRODSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
300 TUTHILL ROAD, NEW SUFFOLK, NY 11956-0152
(516) 375-4777
(631) 734-2412
Mailing address
PO BOX 152, NEW SUFFOLK, NY 11956-0152
(516) 375-4777
(631) 734-2412
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
015130-1
NY
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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