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General NPI Number Information
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NPI Number | 1851349328
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Entity Type | Organization
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Legal Business Name | GRANADOS MEDICAL ASSOCIATES, P. C.
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9 WYNDHAM HILL DR
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City | READING
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State | PA
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Zip | 19606-9575
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Country | US
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Telephone | 610-779-4625
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Fax |
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Provider Business Mailing Address
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Address Line | 9 WYNDHAM HILL DR
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City | READING
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State | PA
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Zip | 19606-9575
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Country | US
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Telephone | 610-779-4625
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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. NICANOR GOMEZ GRANADOS
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Credential | M. D.
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Telephone | 610-779-4625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD014870E
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License Number State | PA
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