MARIANNE L GRANDUSKY PA NPI 1225093289

NPI Information

Marianne L Grandusky, PA is a medical physician assistant in New York, NY. Marianne L Grandusky, PA NPI is 1225093289. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

177 FORT WASHINGTON AVE
MHB 6GN 435
NEW YORK, NY
ZIP 10032-733
Phone: (212) 305-8932
Fax: (212) 305-3035

The NPI 1225093289 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/20/2006 and was last updated on 5/12/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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