Active NPI
Lisa Ann Gryskevicz, OTRL
- Occupational Therapist
- Hazleton, PA
National Provider Identifier
1366640625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OC003420L
- Practice address
- 1000 W 27TH St
Hazleton, PA 18202-9604 - Phone
- (570) 454-8888
- Fax
- (570) 459-9252
- NPI assigned
- Jul 10, 2007
- Last updated
- Jul 10, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OC003420L | PA | Primary |
Addresses
Primary practice location
1000 W 27TH St
Hazleton, PA 18202-9604
Mailing address
18 Priestly St
Wilkes Barre, PA 18702-2515
Phone (570) 821-1180
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
| License | State | Type | Specialty |
|---|---|---|---|
| OC003420L | PA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184025600000",
"number": "1366640625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 PRIESTLY ST",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "187022515",
"telephone_number": "570-821-1180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 W 27TH ST",
"city": "HAZLETON",
"state": "PA",
"postal_code": "182029604",
"telephone_number": "570-454-8888",
"fax_number": "570-459-9252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRYSKEVICZ",
"first_name": "LISA",
"middle_name": "ANN",
"name_prefix": "Miss",
"credential": "OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-10",
"last_updated": "2007-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC003420L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hazleton, PA
- Greater Hazleton Radiology Associates, LLC (Hazleton General Hospital - Professional Services)
- Bonnie Gregory, CRNP
- Griguoli Chiropractic & Rehabilitation Center, P.C.
- Anthony Rocco Griguoli, DC
- Christopher John Grink, MSPT
- Deepak Gupta, DDS
- Joshua Gurin, BA
- Ashly Gutierrez Badia, PA-C
- Pedro Guzman, MD
- Amanda Kathryn Gwiazdowski, LPC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.