Provider Demographics
NPI:1124143417
Name:GROBELNY, ROBERT G (D,C,)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:G
Last Name:GROBELNY
Suffix:
Gender:M
Credentials:D,C,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 GOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14220-1265
Mailing Address - Country:US
Mailing Address - Phone:716-400-8944
Mailing Address - Fax:
Practice Address - Street 1:6180 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-1050
Practice Address - Country:US
Practice Address - Phone:716-651-9011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010356111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor