Provider Demographics
NPI:1104815703
Name:GRUBER, DOROTA (MS, GC)
Entity type:Individual
Prefix:
First Name:DOROTA
Middle Name:
Last Name:GRUBER
Suffix:
Gender:F
Credentials:MS, GC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7206 CALDWELL AVE
Mailing Address - Street 2:MASPETH
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-2619
Mailing Address - Country:US
Mailing Address - Phone:212-342-3423
Mailing Address - Fax:718-383-9199
Practice Address - Street 1:7206 CALDWELL AVE
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-2619
Practice Address - Country:US
Practice Address - Phone:212-342-3423
Practice Address - Fax:718-383-9199
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS