Individual
BRIAN P GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NPP
Contact information
Practice address
54 DALFONSO RD, NEWBURGH, NY 12550-7203
(845) 541-3145
Mailing address
54 DALFONSO RD, NEWBURGH, NY 12550-7203
(845) 541-3145
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F403508
NY
Other
Enumeration date
05/23/2015
Last updated
08/14/2021
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