Individual
MARTHA S GRAYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
170 W 12TH ST, MEDICINE/ GENERAL, NEW YORK, NY 10011-8202
(212) 356-4474
(212) 356-4608
Mailing address
450 W 33RD ST, PBS 12TH FLOOR, NEW YORK, NY 10001-2603
(212) 356-4474
(212) 356-4608
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
143595
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01009287
—
NY
Enumeration date
09/26/2006
Last updated
03/29/2010
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