Individual
DR. PATRICIA ELLEN GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 FRUIT ST, GRB 2 NEURORADIOLOGY, BOSTON, MA 02114-2621
(617) 726-4049
(617) 724-3338
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
157846
MA
2085R0202X
Diagnostic Radiology Physician
157846
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
157846
TUFTS HEALTH PLAN
MA
05
—
3184196
—
MA
01
—
J19320
BCBS MA
MA
Enumeration date
07/06/2006
Last updated
09/11/2025
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