Individual
KENNETH P. GRUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
57 MONTAGUE STREET, APT 8A, BROOKLYN, NY 11201-3358
(917) 882-3587
Mailing address
57 MONTAGUE STREET, APT 8A, BROOKLYN, NY 11201-3358
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
156424 1
NY
207L00000X
Anesthesiology Physician
25MA05061300
NJ
207L00000X
Anesthesiology Physician
MD 014741
LA
Other
Enumeration date
05/10/2006
Last updated
04/30/2008
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