Individual
MARIANNE L GRANDUSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
177 FORT WASHINGTON AVE, MHB 6GN 435, NEW YORK, NY 10032-3733
(212) 305-8932
(212) 305-3035
Mailing address
177 FORT WASHINGTON AVE, MHB 6GN 435, NEW YORK, NY 10032-3733
(585) 766-5675
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0075321
NY
Other
Enumeration date
04/20/2006
Last updated
05/12/2016
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