Individual
DR. ILYA GRINBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
3747 60TH ST, APARTMENT 1A, WOODSIDE, NY 11377-2585
(732) 685-7374
Mailing address
3747 60TH ST, APARTMENT 1A, WOODSIDE, NY 11377-2585
(732) 685-7374
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
298088
NY
207L00000X
Anesthesiology Physician
Primary
ME148804
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME148804
STATE LICENSE
FL
Enumeration date
06/08/2015
Last updated
09/21/2022
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