Individual
MISS BARBARA MARIE GRUNENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
80 BAY SHORE RD, BAY SHORE, NY 11706-3621
(631) 266-4489
Mailing address
80 BAY SHORE RD, BAY SHORE, NY 11706-3621
(631) 266-4489
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
323565901
NY
Other
Enumeration date
06/14/2012
Last updated
09/08/2016
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