Provider Demographics
NPI:1730915968
Name:GRESKIEWICZ, CORINNE (ATR-BC)
Entity type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:GRESKIEWICZ
Suffix:
Gender:F
Credentials:ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1743
Mailing Address - Country:US
Mailing Address - Phone:215-688-8058
Mailing Address - Fax:
Practice Address - Street 1:250 W LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1743
Practice Address - Country:US
Practice Address - Phone:610-649-1080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist