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NPI Code Detail

MEDICARE: BASYA GRUBER LSW

MEDICARE:   BASYA  GRUBER  LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerNJ

General Provider Information

NPI Number : 1508724683
Entity Type Code : Individual
Provider Name (Legal Business Name) : BASYA GRUBER LSW
Provider Business Mailing Address
First Line : 12 ROOSEVELT AVE # 2
Second Line :
City : NORTH HALEDON
State : NJ
Zip : 07508-2824
Country : US
Telephone Number : 908-845-3521
Fax Number :
Provider Business Practice Location Address
First Line : 51 UPPER MONTCLAIR PLZ STE 27
Second Line :
City : MONTCLAIR
State : NJ
Zip : 07043-1340
Country : US
Telephone Number : 973-920-3160
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2026
Last Update Date : 01/15/2026

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Directions to “ BASYA GRUBER LSW” Practice Location

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