Individual
DR. LOLA M. GRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1415 ELM ST, MANCHESTER, NH 03101-1325
(603) 669-3925
Mailing address
PO BOX 725, COOPERSTOWN, NY 13326-0725
(607) 547-3456
(607) 547-6612
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
21444
NH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2016
Last updated
05/19/2021
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