MEDICARE: DR. RUSS D. GRANICH MD

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	207QG0300X	Geriatric Medicine (Family Medicine) Physician	G50400	CA
2	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	G50400	CA
3	207R00000X	Internal Medicine Physician	067712	CT
4	207R00000X	Internal Medicine Physician	G50400	CA
5	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	067712	CT

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	:	1962580589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUSS D. GRANICH MD

Provider Business Mailing Address
First Line	:	104 RIDGEWOOD RD
Second Line	:
City	:	WEST HARTFORD
State	:	CT
Zip	:	06107-2927
Country	:	US
Telephone Number	:	510-928-5848
Fax Number	:

Provider Business Practice Location Address
First Line	:	659 TOWER AVE
Second Line	:
City	:	HARTFORD
State	:	CT
Zip	:	06112-1259
Country	:	US
Telephone Number	:	860-763-7600
Fax Number	:

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	03/19/2025

Similar Medicare Providers

1992702757 — TRINITY HOME HEALTH SERVICES
Practice Location Address:

659 TOWER AVE FL 2
HARTFORD, CT
06112-1259

Practice Phone: 860-763-7600
Practice Fax:

1811052194 — TRINITY HOME HEALTH SERVICES
Practice Location Address:

659 TOWER AVE FL 2
HARTFORD, CT
06112-1259

Practice Phone: 860-763-7600
Practice Fax: 833-854-3579

1174628507 — MS. PHYLLIS CURCIO LCSW
Practice Location Address:

184 N MAIN ST
WEST HARTFORD, CT
06107-1259

Practice Phone: 860-236-2842
Practice Fax: 860-236-2842

1932915592 — MEAGAN FRANCKA SLPA
Practice Location Address:

1300 N HARTFORD AVE
BOLIVAR, MO
65613-1259

Practice Phone: 417-777-5160
Practice Fax:

1972460475 — MS. PATRICE J MATHURINE APRN
Practice Location Address:

196 N MAIN ST
WEST HARTFORD, CT
06107-1259

Practice Phone: 860-614-7471
Practice Fax:

1346828381 — ALVARO JOSE AYALA MD
Practice Location Address:

131 COVENTRY ST
HARTFORD, CT
06112-1548

Practice Phone: 860-714-3690
Practice Fax: 860-714-8541

Directions to “ DR. RUSS D. GRANICH MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.