Individual
EDWARD R GRUBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CN
Contact information
Practice address
1771 MADISON AVE, LAKEWOOD, NJ 08701-1251
(732) 364-2144
(732) 364-3559
Mailing address
1771 MADISON AVE, LAKEWOOD, NJ 08701-1251
(732) 364-2144
(732) 364-3559
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
001929
WA
Other
Enumeration date
11/02/2009
Last updated
11/02/2009
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