Healthcare Provider Details

I. General information

NPI: 1134881444
Provider Name (Legal Business Name): MEGAN GRANSKI PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2021
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 9TH ST
BROOKLYN NY
11215-4008
US

IV. Provider business mailing address

360 9TH ST
BROOKLYN NY
11215-4008
US

V. Phone/Fax

Practice location:
  • Phone: 201-316-7980
  • Fax:
Mailing address:
  • Phone: 201-316-7980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number111171-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: