1679852685 NPI number — MRS. ASHLEY MARIE GRISWOLD DPT

Table of content: MRS. ASHLEY MARIE GRISWOLD DPT (NPI 1679852685)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679852685 NPI number — MRS. ASHLEY MARIE GRISWOLD DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRISWOLD
Provider First Name:
ASHLEY
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCOUTEN
Provider Other First Name:
ASHLEY
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1679852685
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/11/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
515 MOE RD.
Provider Second Line Business Mailing Address:
ACCESS THERAPY GROUP
Provider Business Mailing Address City Name:
CLIFTON PARK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12065
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-280-4294
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
515 MOE RD.
Provider Second Line Business Practice Location Address:
ACCESS THERAPY GROUP
Provider Business Practice Location Address City Name:
CLIFTON PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12065
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-280-4294
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/08/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2251P0200X , with the licence number:  034008-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)