Individual provider Active NPI

Cecilia Grillo, PTA

  • Physical Therapy Assistant
  • Northfield, NJ
National Provider Identifier
1306056650
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
40QB00218900 Issued in NJ
Practice address
1418 New Rd
Suite 3
Northfield, NJ 08225-1179
Phone
(609) 645-8282
Fax
(609) 645-8182
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 40QB00218900 NJ Primary

Addresses

Primary practice location

1418 New Rd
Suite 3
Northfield, NJ 08225-1179

Mailing address

1418 New Rd
Suite 3
Northfield, NJ 08225-1179
Phone (609) 645-8282

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
40QB00218900NJMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy and Living Consultants, PC Past Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306056650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 NEW RD",
            "address_2": "SUITE 3",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251179",
            "telephone_number": "609-645-8282",
            "fax_number": "609-645-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 NEW RD",
            "address_2": "SUITE 3",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251179",
            "telephone_number": "609-645-8282",
            "fax_number": "609-645-8182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRILLO",
        "first_name": "CECILIA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00218900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.