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General NPI Number Information
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NPI Number | 1750476503
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Entity Type | Organization
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Legal Business Name | WILLIAM A GRATTAN MD PC
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 55 MOHAWK STREET SUITE 101
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City | COHOES
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State | NY
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Zip | 12047
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Country | US
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Telephone | 518-233-9500
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Fax | 518-235-4827
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Provider Business Mailing Address
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Address Line | 55 MOHAWK STREET SUITE 101
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City | COHOES
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State | NY
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Zip | 12047
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Country | US
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Telephone | 518-233-9500
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Fax | 518-235-4827
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Authorized Official
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Title or Position | PRESIDENT PEDIATRICIAN
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Name | DR. WILLIAM ANTHONY GRATTON
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Credential | MD
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Telephone | 518-233-9500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F380828
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 076202
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License Number State | NY
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