Grebenchtchikova, Larissa

Grebenchtchikova, Larissa is an individual health care provider with primary practice located at 250 E Dunlap Ave , Phoenix AZ 85020-2825. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is her primary health care specialty. Grebenchtchikova, Larissa can be contacted via phone (602) 943-2381.

Contact Information

Primary practice address
250 E Dunlap Ave Phoenix AZ 85020-2825
Phone: (602) 943-2381
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 003161 New York
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 100498 Wisconsin
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X C169056 California
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X 003161 New York
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 43833 Arizona

Profile Details

NPI number 1093970766
LBN Legal business name Grebenchtchikova, Larissa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2008
Last updated Aug 24th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093970766 NPPES
Wisconsin MEDICAID 100230616

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