Individual
KINZYA BERNICE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
230 N BROAD ST, PHILADELPHIA, PA 19102-1121
(215) 762-7963
Mailing address
509 TREE CROSSINGS PKWY, HOOVER, AL 35244-4041
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
261625
NY
2085R0202X
Diagnostic Radiology Physician
Primary
MD436648
PA
Other
Enumeration date
05/18/2007
Last updated
07/06/2023
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