Healthcare Provider Details

I. General information

NPI: 1104870203
Provider Name (Legal Business Name): THE MARION AND AARON GURAL JCC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 GROVE AVE.
CEDARHURST NY
11516
US

IV. Provider business mailing address

207 GROVE AVE.
CEDARHURST NY
11516
US

V. Phone/Fax

Practice location:
  • Phone: 516-569-6733
  • Fax: 516-569-6917
Mailing address:
  • Phone: 516-569-6733
  • Fax: 516-569-6917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0558111
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. ROBERT DANIELS
Title or Position: CFO
Credential:
Phone: 516-569-6733