Healthcare Provider Details

I. General information

NPI: 1780975102
Provider Name (Legal Business Name): ELIZABETH GRANIERI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2011
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5659 S REX RD
MEMPHIS TN
38119-3821
US

IV. Provider business mailing address

5-11 47TH AVENUE APT 6X
LONG ISLAND CITY NY
11101
US

V. Phone/Fax

Practice location:
  • Phone: 901-763-3636
  • Fax: 901-763-3694
Mailing address:
  • Phone: 901-262-9152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number289190
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: