MEDICARE: DR. MARIA DEL CARMEN GRAU 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
1	103TC0700X	Clinical Psychologist	011024	NY

General Provider Information

NPI Number	:	1639382104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA DEL CARMEN GRAU PH.D.

Provider Business Mailing Address
First Line	:	545 WEST END AVENUE
Second Line	:	10B
City	:	NEW YORK CITY
State	:	NY
Zip	:	10024
Country	:	US
Telephone Number	:	212-865-7210
Fax Number	:

Provider Business Practice Location Address
First Line	:	149 W 93ST.
Second Line	:
City	:	NEW YORK CITY
State	:	NY
Zip	:	10025
Country	:	US
Telephone Number	:	212-865-7210
Fax Number	:

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

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	10/23/2013

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