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General NPI Number Information
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NPI Number | 1013229079
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Entity Type | Organization
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Legal Business Name | DR DENISE GRANDA-GILBERT CLINICAL PSYCHOLOGIST, P.C.
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Dates
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Enumeration Date | 07/07/2010
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Last Update Date | 08/16/2010
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Provider Practice Location Address
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Address Line | 6 STATION SQUARE OFFICE ON STREET LEVEL
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City | FOREST HILLS
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State | NY
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Zip | 11375-5234
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Country | US
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Telephone | 718-268-8081
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Fax | 718-268-2281
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Provider Business Mailing Address
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Address Line | 6 STATION SQUARE OFFICE ON STREET LEVEL
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City | FOREST HILLS
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State | NY
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Zip | 11375-5234
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Country | US
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Telephone | 718-268-8081
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Fax | 718-268-2281
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DENISE GRANDA-GILBERT
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Credential | PH.D.
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Telephone | 718-268-8081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 7280
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License Number State | NY
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