Provider Demographics
NPI:1720024136
Name:GRUBER, STEVEN JEFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JEFFREY
Last Name:GRUBER
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:P O BOX 95000-2150
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-2150
Mailing Address - Country:US
Mailing Address - Phone:212-420-4003
Mailing Address - Fax:212-420-4043
Practice Address - Street 1:10 UNION SQUARE EAST
Practice Address - Street 2:BETH ISRAEL MEDICAL CENTERBAIRD HALLNEPHROLOGY DIVISION
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3805
Practice Address - Country:US
Practice Address - Phone:212-420-4003
Practice Address - Fax:212-420-4043
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2019-04-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY178227207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY64F101Medicare PIN