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1124000369
IVAN M GRYNYSHIN
POTTSVILLE, PA
NPI
1124000369
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207L00000X Anesthesiology
(Licence: PA MD423998)
Enumeration Date
2005-11-15
Last Update Date
2009-04-20
Business Address
IVAN M GRYNYSHIN MD
420 S JACKSON ST
POTTSVILLE, PA 17901-3625
Phone number: 570-346-7797
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Mailing Address
IVAN M GRYNYSHIN MD
PO BOX 390
SCRANTON, PA 18501-0390
Phone number: 570-346-7797
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