Provider Demographics
NPI:1427281005
Name:GRYBOSKI, LEAH L (BS)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:L
Last Name:GRYBOSKI
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 WATERFRONT DR E
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:PA
Mailing Address - Zip Code:15120-5004
Mailing Address - Country:US
Mailing Address - Phone:412-464-2323
Mailing Address - Fax:412-464-2623
Practice Address - Street 1:360 WATERFRONT DR E
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:PA
Practice Address - Zip Code:15120-5004
Practice Address - Country:US
Practice Address - Phone:412-464-2323
Practice Address - Fax:412-464-2623
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-28
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039362L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist