Individual
TOBIAS GRONEVELDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1585 209TH ST, BAYSIDE, NY 11360-1127
(718) 877-7976
(718) 423-6617
Mailing address
1585 209TH ST, BAYSIDE, NY 11360-1127
(718) 877-7976
(718) 423-6617
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558732420
—
NY
Enumeration date
05/21/2016
Last updated
05/21/2016
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