Provider Demographics
NPI:1629379979
Name:GRUEN, BEN ZION (DC)
Entity type:Individual
Prefix:DR
First Name:BEN
Middle Name:ZION
Last Name:GRUEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 BROADWAY
Mailing Address - Street 2:SUITE 1800
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-4381
Mailing Address - Country:US
Mailing Address - Phone:212-769-3210
Mailing Address - Fax:
Practice Address - Street 1:150 BROADWAY
Practice Address - Street 2:SUITE 1800
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4381
Practice Address - Country:US
Practice Address - Phone:212-769-3210
Practice Address - Fax:212-769-3204
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1854111N00000X
NY011882111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor