MEDICARE: DIANA GRINBERG MD

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
1	207P00000X	Emergency Medicine Physician	243218	NY
2	207P00000X	Emergency Medicine Physician	25MA08221300	NJ

General Provider Information

NPI Number	:	1679769111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA GRINBERG MD

Provider Business Mailing Address
First Line	:	160 N MIDLAND AVE
Second Line	:
City	:	NYACK
State	:	NY
Zip	:	10960-1998
Country	:	US
Telephone Number	:	845-348-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 N MIDLAND AVE
Second Line	:
City	:	NYACK
State	:	NY
Zip	:	10960-1998
Country	:	US
Telephone Number	:	845-348-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2007
Last Update Date	:	09/10/2025

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Directions to “ DIANA GRINBERG MD” Practice Location

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