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General NPI Number Information
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NPI Number | 1508724683
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Entity Type | Individual
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Provider Name | BASYA GRUBER LSW
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Gender | Female
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Dates
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Enumeration Date | 01/15/2026
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 51 UPPER MONTCLAIR PLZ STE 27
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City | MONTCLAIR
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State | NJ
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Zip | 07043-1340
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Country | US
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Telephone | 973-920-3160
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Fax |
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Provider Business Mailing Address
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Address Line | 12 ROOSEVELT AVE # 2
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City | NORTH HALEDON
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State | NJ
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Zip | 07508-2824
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Country | US
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Telephone | 908-845-3521
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | NJ
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