Individual
CAROLYN HEYWARD GROSVENOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
113 HOLLAND AVE, STRATTON VA MEDICAL CENTER MVAC-PRIMARY CARE, ALBANY, NY 12208-3410
(518) 626-6560
(518) 626-6563
Mailing address
113 HOLLAND AVE, STRATTON VA MEDICAL CENTER MVAC-PRIMARY CARE, ALBANY, NY 12208-3410
(518) 626-6560
(518) 626-6563
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
146531
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10000815
CDPHP
NY
01
—
19992
EBCBS
NY
Enumeration date
07/05/2006
Last updated
05/06/2011
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