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General NPI Number Information
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NPI Number | 1649902529
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Entity Type | Individual
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Provider Name | RACHEL GRUEN
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Gender | Female
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Dates
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Enumeration Date | 06/28/2022
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 1312 38TH ST
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City | BROOKLYN
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State | NY
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Zip | 11218-3612
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Country | US
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Telephone | 718-686-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 1567 61ST ST APT 2R
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City | BROOKLYN
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State | NY
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Zip | 11219-6590
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Country | US
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Telephone | 347-587-9454
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 003781
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License Number State | NY
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