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Individual

EVA LILLIAN GRUNBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
173 EAST AVENUE, NEW CANAAN, CT 06840
(203) 972-4250
(203) 801-2126
Mailing address
173 EAST AVENUE, NEW CANAAN, CT 06840
(203) 972-4250
(203) 801-2126

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
027537
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000121762001
UHC
01
00127537900
BLUE CARE FAMILY
01
010027537CT01
ANTHEM BCBS
01
4239077
AETNA
01
6053905
CIGNA
01
ZP292
OXFORD
Enumeration date
11/29/2006
Last updated
07/08/2007
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