Provider Demographics
NPI:1558409011
Name:GRUENBERG, ALAN MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:MARK
Last Name:GRUENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:950 E HAVERFORD RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3850
Mailing Address - Country:US
Mailing Address - Phone:610-527-4217
Mailing Address - Fax:610-527-4628
Practice Address - Street 1:950 E HAVERFORD RD
Practice Address - Street 2:SUITE 302
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3850
Practice Address - Country:US
Practice Address - Phone:610-527-4217
Practice Address - Fax:610-527-4628
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD 034523-E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry