Individual
DR. BRUCE A. GRELLONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
120 W. 57TH ST., NEW YORK, NY 10019-3371
(212) 632-4666
(212) 584-8484
Mailing address
205 W. 89TH ST., NEW YORK, NY 10024-1838
(212) 595-1788
(212) 875-8797
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4702-1
NY
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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