Individual
JACQUELINE MARIE GRIBKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
125 MINEOLA AVE STE 200, ROSLYN HEIGHTS, NY 11577-2042
(800) 633-8446
Mailing address
279 CHARLES AVE, MASSAPEQUA PARK, NY 11762-1802
(516) 426-4293
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
06/16/2021
Last updated
06/16/2021
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