Basic Information
| Provider Information | |||||||||
| NPI: | 1013058171 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GROBMAN | ||||||||
| FirstName: | LINDSAY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 95 UNIVERSITY PL | ||||||||
| Address2: | FL 8 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100034515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126041316 | ||||||||
| FaxNumber: | 2126041320 | ||||||||
| Practice Location | |||||||||
| Address1: | 1462 212TH ST | ||||||||
| Address2: | |||||||||
| City: | BAYSIDE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113601108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9175797542 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/10/2007 | ||||||||
| LastUpdateDate: | 09/27/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 025485 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.