Patrick T Griggs

Individual provider Active NPI Speech-Language Pathologist · Pemberton, NJ

NPI 1003309782 · NPPES record last updated Jun 7, 2018

Key facts

NPI
1003309782
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
TL-3063 (NJ)
Practice address
43 Elizabeth St
Pemberton, NJ 08068-1232
Phone
(609) 316-0195
Fax
(609) 353-1549
NPI assigned
Jun 7, 2018
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
TL-3063NJMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Exceptional Kidz Rehabilitation Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X TL-3063 NJ Yes

Addresses

Primary practice location

43 Elizabeth St
Pemberton, NJ 08068-1232

Mailing address

43 Elizabeth St
Pemberton, NJ 08068-1232
Phone (609) 316-0195

Other providers in Pemberton, NJ

All providers in Pemberton, NJ · Speech-Language Pathologist in New Jersey

Sources for this page

Verify at the official NPI Registry.