Provider Demographics
NPI:1215053038
Name:JUDITH F GRUBER
Entity type:Organization
Organization Name:JUDITH F GRUBER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:F
Authorized Official - Last Name:GRUBER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CCET
Authorized Official - Phone:718-722-7907
Mailing Address - Street 1:141 JORALEMON ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4010
Mailing Address - Country:US
Mailing Address - Phone:718-722-7907
Mailing Address - Fax:718-222-9338
Practice Address - Street 1:141 JORALEMON ST APT 2B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4010
Practice Address - Country:US
Practice Address - Phone:718-722-7907
Practice Address - Fax:718-222-9338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty