# GRENVILLE MEDICAL PC

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

## Provider details

- **NPI number:** 1316961071
- **Authorized official:** DR. BERNARD KABAKOW MD (OWNER)
- **Authorized official phone:** (917) 576-4481

## Contact information

- **Practice address:** 308A E 15TH ST, NEW YORK, NY 10003-4001
- **Practice address phone:** (212) 674-4455
- **Mailing address:** 308A E 15TH ST, NEW YORK, NY 10003-4001
- **Mailing address phone:** (212) 674-4455

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RH0003X | Hematology & Oncology Physician | 075329 | NY | Yes |

## Other

- **Enumeration date:** 07/27/2006
- **Last updated:** 12/28/2007