Provider Demographics
NPI:1265672752
Name:GROSBERG, ROBYN (SLP)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:GROSBERG
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14103 72ND CRES
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2329
Mailing Address - Country:US
Mailing Address - Phone:718-261-2529
Mailing Address - Fax:
Practice Address - Street 1:14103 72ND CRES
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-2329
Practice Address - Country:US
Practice Address - Phone:718-261-2529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014029-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist