# GRAND STREET MEDICINE & REHABILITATION P C

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447381538
- **Authorized official:** TANYA GLIPONEO (MEDICAL BILLER)
- **Authorized official phone:** (212) 539-0257

## Contact information

- **Practice address:** 407 ROCKAWAY AVE, BROOKLYN, NY 11212-5635
- **Practice address phone:** (718) 750-7680
- **Mailing address:** 460 GRAND ST, NEW YORK, NY 10002-4058
- **Mailing address phone:** (212) 539-0257
- **Mailing address fax:** (212) 677-4853

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 148797 | NY | Yes |

## Other

- **Enumeration date:** 03/08/2007
- **Last updated:** 05/03/2023