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NPI Code Detail

MEDICARE: OLIVIA GRANT

MEDICARE:   OLIVIA  GRANT
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
1163W00000XRegistered Nurse589368NY
2363LF0000XFamily Nurse Practitioner342913NY

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 : 1518274836
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA GRANT
Provider Business Mailing Address
First Line : 3709 FLATLANDS AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-3507
Country : US
Telephone Number : 718-444-7766
Fax Number :
Provider Business Practice Location Address
First Line : 3709 FLATLANDS AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-3507
Country : US
Telephone Number : 718-444-7766
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2010
Last Update Date : 05/07/2024

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Directions to “ OLIVIA GRANT ” Practice Location

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