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Individual

MARCIA GRICKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A.,C.C.C.-A

Contact information

Practice address
3663 ROUTE 9 N STE 102, OLD BRIDGE, NJ 08857-3518
(732) 679-7575
Mailing address
560 WHITE PLAINS RD, SUITE 500, TARRYTOWN, NY 10591-5113
(914) 984-2534

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
41YA00087600
NJ
231H00000X
Audiologist
A-00874
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0972309
OH
05
20855147
OH
01
4246971
MEDICARE PTAN
01
P00681450
MEDICARE RAILROAD PTAN
OH
Enumeration date
07/28/2008
Last updated
03/14/2025
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