Provider Demographics
NPI:1104323484
Name:GRUSSGOTT, SARAH LEAH I (MS)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:LEAH
Last Name:GRUSSGOTT
Suffix:I
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:YELED V'YALDA'S
Mailing Address - Street 2:1312-38 STREET
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218
Mailing Address - Country:US
Mailing Address - Phone:718-686-3700
Mailing Address - Fax:
Practice Address - Street 1:YELED V'YALDA'S
Practice Address - Street 2:1312-38 STREET
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218
Practice Address - Country:US
Practice Address - Phone:718-686-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist