Healthcare Provider Details

I. General information

NPI: 1881525632
Provider Name (Legal Business Name): KATHY ANN GRANT RN, ACUPUNCTURIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 RADIO CIRCLE DR STE C
MOUNT KISCO NY
10549-2644
US

IV. Provider business mailing address

136 RADIO CIRCLE DR STE C
MOUNT KISCO NY
10549-2644
US

V. Phone/Fax

Practice location:
  • Phone: 914-393-2075
  • Fax: 914-244-6396
Mailing address:
  • Phone:
  • Fax: 914-244-6396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number001638
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: