Organization
STATLINE ACCESS LLC
Active
Other names
STATLINE ACCESS LLC
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN GRUBER PA (PHYSICIAN ASSISTANT)
(914) 301-3360
Entity
Organization
Contact information
Practice address
3 SONOMA RD, CORTLANDT MANOR, NY 10567-5129
(914) 301-3360
Mailing address
3 SONOMA RD, CORTLANDT MANOR, NY 10567-5129
(914) 301-3360
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
03/01/2019
Last updated
03/01/2019
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