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General NPI Number Information
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NPI Number | 1003961699
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Entity Type | Organization
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Legal Business Name | SUSAN L.GRANT, M.D.,P.C.
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 02/06/2008
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Provider Practice Location Address
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Address Line | 8 E 83RD ST
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City | NEW YORK
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State | NY
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Zip | 10028-0418
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Country | US
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Telephone | 212-769-0755
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Fax |
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Provider Business Mailing Address
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Address Line | 8 E 83RD ST
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City | NEW YORK
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State | NY
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Zip | 10028-0418
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Country | US
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Telephone | 212-769-0755
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUSAN L GRANT
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Credential | M.D.
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Telephone | 212-760-0755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 143686
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License Number State | NY
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