National Provider Identifier
Jennifer Joan Lipa Gruttadaro, RPT
Jennifer Joan Lipa Gruttadaro, RPT is listed in the NPPES registry with a primary specialty of Physical Therapist in Penfield, NY and a listed phone number of (347) 341-3501.
Profile Overview
- NPI
- 1326224379
- Provider Type
- Individual
- Primary Specialty
- Physical Therapist
- Enumeration Date
- January 20, 2008
- Last Updated
- September 06, 2023
Practice Location
- 258 Penbrooke Dr
- Penfield, NY 14526-2022
Phone: (347) 341-3501
Specialties
- Physical Therapist (225100000X)
Full Record
- NPI
- 1326224379
- Entity Type
- Individual
- Last Name
- Gruttadaro
- First Name
- Jennifer Joan
- Middle Name
- Lipa
- Name Prefix
- Mrs.
- Credential
- RPT
- Provider Other Last Name
- Lipa
- Provider Other First Name
- Jennifer Joan
- Provider Other Middle Name
- De Guzman
- Provider Other Name Prefix Text
- Miss
- Provider Other Credential Text
- RPT
- Provider Other Last Name Type Code
- 2
- Mailing Street Address
- 258 Penbrooke Dr
- Mailing City
- Penfield
- Mailing State
- NY
- Mailing ZIP Code
- 14526-2022
- Mailing Country
- US
- Mailing Phone
- (347) 341-3501
- Practice Street Address
- 258 Penbrooke Dr
- Practice City
- Penfield
- Practice State
- NY
- Practice ZIP Code
- 14526-2022
- Practice Country
- US
- Practice Phone
- (347) 341-3501
- Enumeration Date
- January 20, 2008
- Last Updated
- September 06, 2023
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- September 06, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Therapist (225100000X)