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General NPI Number Information
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NPI Number | 1689038259
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Entity Type | Individual
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Provider Name | GAYLE M GRENADIER D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/11/2016
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Last Update Date | 04/11/2016
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Provider Practice Location Address
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Address Line | 800 5TH AVE 34B
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City | NEW YORK
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State | NY
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Zip | 10065-7216
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Country | US
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Telephone | 212-639-1258
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Fax | 212-639-1662
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Provider Business Mailing Address
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Address Line | 800 5TH AVE 34B
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City | NEW YORK
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State | NY
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Zip | 10065-7216
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Country | US
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Telephone | 212-639-1258
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Fax | 212-639-1662
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 037979-1
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License Number State | NY
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