Individual
DR. BRUCE JOHN GRATTAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO, MS, RD
Contact information
Practice address
GOUVERNEUR HOSPITAL, 77 WEST BARNEY STREET, GOUVERNEUR, NY 13642-1040
(315) 287-1000
Mailing address
125 BRICKHILL AVE UNIT 346, SOUTH PORTLAND, ME 04106-2188
(860) 933-1339
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
316792
NY
207P00000X
Emergency Medicine Physician
34.015003
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2019
Last updated
05/08/2023
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