Individual
FANI GRUBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
169 MADISON AVE STE 15370, NEW YORK, NY 10016-5101
(844) 484-7362
Mailing address
600 NORTHERN BLVD, ALBANY, NY 12204-1004
(518) 471-3221
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
23 019861
NY
Other
Enumeration date
07/14/2016
Last updated
05/20/2025
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