Individual
DR. ANDREW MOYER GRUNEBAUM
Active
Individual
DR. ANDREW MOYER GRUNEBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
001760
CT
103TC0700X
Clinical Psychologist
Primary
001760
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060001760CT01
ANTHEM BLUE CROSS ID
CT
01
—
4309291
AETNA PIN NUMBER
CT
01
—
6893902
GHI-VALUEOPTIONS ID
CT
Enumeration date
02/02/2007
Last updated
10/05/2010
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