Individual
JEANNE LORRAINE GRICOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
300 HOLLYWOOD BLVD, ORWIGSBURG, PA 17961-2426
(570) 366-1557
(570) 366-3981
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS015740
PA
207R00000X
Internal Medicine Physician
OT013362
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102819394
—
PA
Enumeration date
05/11/2010
Last updated
08/24/2020
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