Individual
MR. JEROME A A GRISTINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
150 LOCKWOOD AVE, SUITE 10, NEW ROCHELLE, NY 10801
(914) 636-4466
(914) 636-0611
Mailing address
150 LOCKWOOD AVE, SUITE 10, NEW ROCHELLE, NY 10801
(914) 636-4466
(914) 636-0611
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0866131
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00134634
—
NY
Enumeration date
08/08/2006
Last updated
07/08/2007
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