Individual
JOAN GRANITSAS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
280 BEACH ST, REVERE, MA 02151-3143
(781) 289-5057
(781) 289-4485
Mailing address
280 BEACH ST, REVERE, MA 02151-3143
(781) 289-5057
(781) 289-4485
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
214641
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0350231
—
MA
01
—
NP9820
BCBS
MA
Enumeration date
07/07/2005
Last updated
07/08/2007
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