Provider Demographics
NPI:1720339310
Name:GRIGORAS, ANA MARIA (PHD)
Entity type:Individual
Prefix:
First Name:ANA MARIA
Middle Name:
Last Name:GRIGORAS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6553 77TH PL
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-2203
Mailing Address - Country:US
Mailing Address - Phone:646-515-1389
Mailing Address - Fax:
Practice Address - Street 1:6553 77TH PL
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-2203
Practice Address - Country:US
Practice Address - Phone:646-515-1389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist