Individual
DR. IVAN GRUNBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
38 6TH AVE FL 2, BROOKLYN, NY 11217
(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
146673-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00962161
—
NY
Enumeration date
06/09/2005
Last updated
07/11/2018
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