Individual
GRANT K EISELEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
27 HUNTINGTON BRK, ROCHESTER, NY 14625-1810
(585) 261-3404
(585) 261-3404
Mailing address
PO BOX 25471, ROCHESTER, NY 14625-0471
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
5742
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD6778
—
AK
Enumeration date
06/10/2006
Last updated
10/17/2007
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