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NPI 1992751853

NPI 1992751853 : ALISON GRANN MD : LIVINGSTON, NJ

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General NPI Number Information
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    NPI Number           |    1992751853
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    Entity Type          |    Individual 
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    Provider Name        |    ALISON GRANN MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/25/2006
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    Last Update Date     |    12/07/2012
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Provider Practice Location Address
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    Address Line         |    94 OLD SHORT HILLS RD 
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    City                 |    LIVINGSTON
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    State                |    NJ
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    Zip                  |    07039-5672
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    Country              |    US
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    Telephone            |    973-322-5638
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    11 CHAUCER RD 
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    City                 |    SHORT HILLS
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    State                |    NJ
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    Zip                  |    07078-2925
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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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        |    2085R0203X
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    Taxonomy Name        |    Therapeutic Radiology Physician
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    License Number       |    MA07133
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    License Number State |    NJ
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