MEDICARE: ANNA GRINKO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	206993	NY
2	207RP1001X	Pulmonary Disease Physician	206993	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275505430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA GRINKO M.D.

Provider Business Mailing Address
First Line	:	400 E 66TH ST
Second Line	:	11 B
City	:	NEW YORK
State	:	NY
Zip	:	10065-9314
Country	:	US
Telephone Number	:	917-837-2030
Fax Number	:

Provider Business Practice Location Address
First Line	:	1665 BEDFORD AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-2023
Country	:	US
Telephone Number	:	718-756-4000
Fax Number	:	718-756-4003

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	10/12/2015

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