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Individual

SAMUEL GRUBMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
154 W 14TH ST FL 4, NEW YORK, NY 10011-7330
(212) 616-4122
(212) 616-4124
Mailing address
70 E 10TH ST APT 12K, NEW YORK, NY 10003-5124

Taxonomy

Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
162736
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01586736
NY
Enumeration date
06/22/2005
Last updated
03/25/2021
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