Individual
ELIZABETH J GRANATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
20 CUMBERLAND HILL RD, SUITE 104, WOONSOCKET, RI 02895-4883
(401) 765-4100
Mailing address
20 CUMBERLAND HILL RD, UNIT 104, WOONSOCKET, RI 02895-4854
(401) 765-4100
(401) 765-2300
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA00944
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA00944
STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS DEPARTMENT OF HEALTH
RI
Enumeration date
04/18/2017
Last updated
04/20/2017
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