Individual
TATYANA GRINCHENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
506 HAMBURG TPKE STE 201, WAYNE, NJ 07470-2069
(201) 282-8356
(888) 502-1596
Mailing address
363 STURBRIDGE RD, WYCKOFF, NJ 07481-1562
(917) 449-6890
(888) 502-1596
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
235641
NY
207RR0500X
Rheumatology Physician
Primary
MB082529
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0149781
—
NJ
Enumeration date
02/15/2007
Last updated
11/04/2016
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