Individual
MR. JACK GRUENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R. PH.
Contact information
Practice address
27 FOURTH STREET, PARK RIDGE, NJ 07656-1902
(201) 248-5207
Mailing address
27 FOURTH STREET, PARK RIDGE, NJ 07656-1902
(201) 248-5207
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
054468
NY
183500000X
Pharmacist
16429
NJ
Other
Enumeration date
05/19/2010
Last updated
05/19/2010
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