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Organization
DEBRA GRUDA LCSW PC
Active
Organization
DEBRA GRUDA LCSW PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA GRUDA LCSW R (LICENSED CLINICAL SOCIAL WORKER)
(516) 729-1530
Entity
Organization
Contact information
Practice address
475 E MAIN ST, SUITE 211, PATCHOGUE, NY 11772-3121
(516) 729-1530
Mailing address
PO BOX 732, MASSAPEQUA PARK, NY 11762-0732
(516) 729-1530
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/06/2016
Last updated
05/06/2016
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