Individual
FERN A GRUBER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3702 QUENTIN RD, BROOKLYN, NY 11234-4206
(718) 339-3161
Mailing address
23 LEONARD RD, SYOSSET, NY 11791-6705
(718) 339-3161
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
040664
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02499925
—
NY
Enumeration date
01/05/2006
Last updated
07/08/2007
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