Provider Demographics
NPI:1689987513
Name:GRUBER, CYNTHIA (MA, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:GRUBER
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:981 E PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1446
Mailing Address - Country:US
Mailing Address - Phone:516-449-9899
Mailing Address - Fax:
Practice Address - Street 1:801 E PARK AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-2709
Practice Address - Country:US
Practice Address - Phone:516-889-7297
Practice Address - Fax:516-889-7299
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004351-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist