Provider Demographics
NPI:1952506792
Name:GRAND CENTRAL PHYSICAL MEDICINE&REHABILITATION PC
Entity Type:Organization
Organization Name:GRAND CENTRAL PHYSICAL MEDICINE&REHABILITATION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DORINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DRUKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:212-867-0405
Mailing Address - Street 1:315 MADISON AVE RM 702
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5434
Mailing Address - Country:US
Mailing Address - Phone:212-867-0405
Mailing Address - Fax:
Practice Address - Street 1:315 MADISON AVE RM 702
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5434
Practice Address - Country:US
Practice Address - Phone:212-867-0405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty