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NPI Code Detail

MEDICARE: DR. THOMAS H GRANT PH.D.

MEDICARE: DR. THOMAS H GRANT PH.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
1103TC0700XClinical Psychologist011779NY

Other Identifiers

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

General Provider Information

NPI Number : 1437236247
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS H GRANT PH.D.
Provider Business Mailing Address
First Line : 257 MAIN ST
Second Line :
City : NEW PALTZ
State : NY
Zip : 12561-1610
Country : US
Telephone Number : 845-256-9528
Fax Number : 845-256-9528
Provider Business Practice Location Address
First Line : 257 MAIN ST
Second Line :
City : NEW PALTZ
State : NY
Zip : 12561-1610
Country : US
Telephone Number : 845-256-9528
Fax Number : 845-256-9528
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 10/03/2011

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