Individual
LEE D GRANUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
41 UNION SQ W STE 1328, NEW YORK, NY 10003-3252
(917) 225-1401
Mailing address
1751 2ND AVE APT 16A, NEW YORK, NY 10128-5378
(571) 474-4921
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/23/2021
Last updated
11/23/2021
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