DR. Mark Vincent Grudberg, PH.D.

NPI #1932339157 in Maspeth, New York

Provider Information

NPI Number: 1932339157
Entity Type: Individual
Name: DR. Mark Vincent Grudberg, PH.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Psychologist - Clinical
Credential: PH.D.
Enumeration Date: Jul 22, 2009
Last Updated: Mar 5, 2012

Practice Location

Address: 6083 71ST ST
City: Maspeth
State: New York
ZIP Code: 11378-2913
Phone: (888) 342-6002

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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