Provider Demographics
NPI:1093090250
Name:GROSSMAN, TOBY (OTR)
Entity Type:Individual
Prefix:
First Name:TOBY
Middle Name:
Last Name:GROSSMAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1953 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3615
Mailing Address - Country:US
Mailing Address - Phone:718-375-1490
Mailing Address - Fax:718-375-1490
Practice Address - Street 1:1953 E 22ND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3615
Practice Address - Country:US
Practice Address - Phone:718-375-1490
Practice Address - Fax:718-375-1490
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016787-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist