JORDANIA GRULLON PA-C NPI 1679298400

NPI Information

  • NPI: 1679298400
  • Provider Name: JORDANIA GRULLON, PA-C
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 10 PARK PL
    HAZLE TOWNSHIP, PA
    ZIP 18202
  • Phone: (570) 454-1400

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NPI Details

Jordania Grullon, PA-C is a medical physician assistant in Hazle Township, PA with 3 years of experience. Jordania Grullon, PA-C NPI is 1679298400. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

10 PARK PL
HAZLE TOWNSHIP, PA
ZIP 18202-885
Phone: (570) 454-1400

The NPI 1679298400 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/4/2022 and was last updated on 10/4/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedicalMA064032PENNSYLVANIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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