# MARTIN I GRANOFF MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104936061
- **Authorized official:** MARTIN IRVING GRANOFF MD (PHYSICIAN)
- **Authorized official phone:** (631) 369-3800

## Contact information

- **Practice address:** 554 LARKFIELD ROAD, SUTIE 105, EAST NORTHPORT, NY 11731
- **Practice address phone:** (631) 369-3800
- **Practice address fax:** (631) 368-3802
- **Mailing address:** PO BOX 899, EAST NORTHPORT, NY 11731-0526
- **Mailing address phone:** (631) 369-3800
- **Mailing address fax:** (631) 368-3802

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 211787 | NY | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 12/07/2007