Provider Demographics
NPI:1992942239
Name:GRIMALDI, GABRIELLE E (MA, ATR-BC, LCAT)
Entity type:Individual
Prefix:MS
First Name:GABRIELLE
Middle Name:E
Last Name:GRIMALDI
Suffix:
Gender:F
Credentials:MA, ATR-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 EDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-2902
Mailing Address - Country:US
Mailing Address - Phone:914-738-7025
Mailing Address - Fax:
Practice Address - Street 1:904 EDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NY
Practice Address - Zip Code:10803-2902
Practice Address - Country:US
Practice Address - Phone:914-738-7025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001208-1221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist