| Doctor Name: | PAMELA H. GRUBER |
| NPI Number: | 1104077999 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 002376 |
| Business Practice Address: | 380 Washington Avenue Roosevelt, NY - 11575 |
| Business Phone Number: | 5163782000 |
| Business Fax Number: | |
| Mailing Address: | 71 Slate Lane, LEVITTOWN |
| State: | NY |
| Postal Code: | 11756 |
| Phone Number: | 5166598343 |
| Fax Number: | |
| NPI Enumeration Date: | 10/10/2008 |
| NPI Last Update Date: | 10/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 002376 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |