Jamie Leigh Gruber, MSED
Individual provider Active NPI Early Intervention Provider Agency · South Dayton, NY
NPI 1831459528 · NPPES record last updated May 29, 2012
Key facts
- NPI
- 1831459528
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Early Intervention Provider Agency 252Y00000X
- License
- 1934058 (NY)
- Practice address
- 12878 Route 39
South Dayton, NY 14138-9716 - Phone
- (716) 785-7876
- NPI assigned
- May 29, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1934058 | NY | MD | Early Intervention Provider Agency |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Early Intervention Provider Agency | 252Y00000X | 1934058 | NY | Yes |
Addresses
Primary practice location
12878 Route 39
South Dayton, NY 14138-9716
Mailing address
12878 Route 39
South Dayton, NY 14138-9716
Phone (716) 785-7876
Other providers in South Dayton, NY
- Joanne Siergiej Arnold
- Dawn Rae Eklum
- Todd Eric Eklum
- Patricia Hills
- Kara Michele Johnson
- Barbara Katherine Keib-Nelson
- Jill Ann Kenney
- Theresa Kerzner
All providers in South Dayton, NY · Early Intervention Provider Agency in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.