Provider Demographics
NPI:1851390942
Name:GRINBERG, DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:GRINBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 WHITE PLAINS RD FL 4
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5139
Mailing Address - Country:US
Mailing Address - Phone:914-984-2546
Mailing Address - Fax:
Practice Address - Street 1:1 CROSFIELD AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2222
Practice Address - Country:US
Practice Address - Phone:845-727-1370
Practice Address - Fax:845-727-1377
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY217371207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY217371-1OtherLICENSE
NY217371-1OtherLICENSE