Individual
MRS. BRENDA GUBERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
43 REYNOLDS DRIVE, LIDO BEACH, NY 11561
(516) 313-5860
Mailing address
43 REYNOLDS DRIVE, LIDO BEACH, NY 11561
(516) 313-5860
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
645E6123
NY
Other
Enumeration date
09/07/2022
Last updated
09/07/2022
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