Organization
BROOKLYN UROLOGY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN GRUNBERGER M.D. (PRESIDENT)
(516) 569-0696
Entity
Organization
Contact information
Practice address
1 PROSPECT PARK W, SUITE C, BROOKLYN, NY 11215-1601
(718) 230-7788
(718) 230-8017
Mailing address
141 COMBS AVE, WOODMERE, NY 11598-1432
(516) 569-0696
(516) 569-3677
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
146673
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01794123
—
NY
Enumeration date
05/28/2006
Last updated
04/01/2009
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