Provider Demographics
NPI:1801267265
Name:GRILL, ZACHARY WILLIAM
Entity type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:WILLIAM
Last Name:GRILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 38TH ST APT C9
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-1819
Mailing Address - Country:US
Mailing Address - Phone:516-864-9615
Mailing Address - Fax:
Practice Address - Street 1:2180 38TH ST APT C9
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-1819
Practice Address - Country:US
Practice Address - Phone:516-864-9615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-12
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health