Individual
DR. LISA MOED GRUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7901 4TH AVE, BROOKLYN, NY 11209-3957
(718) 791-5800
Mailing address
330 E 70TH ST, APT 5D, NEW YORK, NY 10021-8634
(917) 647-8112
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
229198
NY
Other
Enumeration date
05/08/2006
Last updated
07/08/2007
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