Wilson Grillo, Cynthia Mae

Wilson Grillo, Cynthia Mae is an individual health care provider with primary practice located at 100 South St Suite 102, Southbridge MA 01550-4051. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wilson Grillo, Cynthia Mae can be contacted via phone (508) 764-3194.

Contact Information

Primary practice address
100 South St Suite 102 Southbridge MA 01550-4051
Phone: (508) 764-3194
Fax: (508) 765-5458
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 152581 Massachusetts

Profile Details

NPI number 1366458457
LBN Legal business name Wilson Grillo, Cynthia Mae
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2006
Last updated Feb 1st, 2012 - about 13 years ago

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 1366458457 NPPES
Massachusetts MEDICAID 220019

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