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NPI Code Detail

MEDICARE: OLIVIA GRANT RN

MEDICARE:   OLIVIA  GRANT  RN
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
1163WR0400XRehabilitation Registered Nurse790453NY

General Provider Information

NPI Number : 1942882055
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA GRANT RN
Provider Business Mailing Address
First Line : 1850 LAFAYETTE AVE APT 6H
Second Line :
City : BRONX
State : NY
Zip : 10473-2837
Country : US
Telephone Number : 203-824-6235
Fax Number :
Provider Business Practice Location Address
First Line : 1000 PELHAM PKWY S
Second Line :
City : BRONX
State : NY
Zip : 10461-1003
Country : US
Telephone Number : 718-409-8200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2021
Last Update Date : 04/27/2021

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Directions to “ OLIVIA GRANT RN” Practice Location

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