Provider Demographics
NPI:1588790208
Name:JOSEPH A GRILLO D.C.P.C.
Entity type:Organization
Organization Name:JOSEPH A GRILLO D.C.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SIMONE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRITTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-645-2200
Mailing Address - Street 1:10 VAN SICKLEN ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2739
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 VAN SICKLEN ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2739
Practice Address - Country:US
Practice Address - Phone:718-645-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX8B663Medicare ID - Type Unspecified