Organization
RICHARD GRAYSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD JEFFREY GRAYSON D.P.M. (OWNER)
(860) 677-7733
Entity
Organization
Contact information
Practice address
40 AVON MEADOW LN, AVON, CT 06001-3753
(860) 677-7733
Mailing address
40 AVON MEADOW LN, AVON, CT 06001-3753
(860) 677-7733
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
P313
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004050050
—
CT
Enumeration date
12/03/2007
Last updated
11/23/2010
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