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General NPI Number Information
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NPI Number | 1174085898
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Entity Type | Individual
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Provider Name | GREGORY GRINBERG
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Gender | Male
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Dates
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Enumeration Date | 04/02/2019
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 222 STATION PLZ N STE 510
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City | MINEOLA
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State | NY
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Zip | 11501-3893
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Country | US
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Telephone | 516-663-2521
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Fax |
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Provider Business Mailing Address
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Address Line | 193 OXFORD ST
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City | BROOKLYN
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State | NY
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Zip | 11235-2310
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Country | US
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Telephone | 917-538-1064
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 320236
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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