Provider Demographics
NPI:1528143823
Name:GROBER, ELLEN H (PHD)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:H
Last Name:GROBER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 BEECHWOOD TER
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-1701
Mailing Address - Country:US
Mailing Address - Phone:718-920-8973
Mailing Address - Fax:914-963-5602
Practice Address - Street 1:2600 NETHERLAND AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-4801
Practice Address - Country:US
Practice Address - Phone:718-796-7934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0075842084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology