Provider Demographics
NPI:1417188202
Name:GRINBERG, ELINA (DPM)
Entity Type:Individual
Prefix:DR
First Name:ELINA
Middle Name:
Last Name:GRINBERG
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 OCEANA DR E APT 4G
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6688
Mailing Address - Country:US
Mailing Address - Phone:646-441-7309
Mailing Address - Fax:
Practice Address - Street 1:65 OCEANA DR E APT 4G
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6688
Practice Address - Country:US
Practice Address - Phone:646-441-7309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006327213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery