Organization
MARK GRANATA, DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK GRANATA DPM (PODIATRIST)
(973) 373-0955
Entity
Organization
Contact information
Practice address
804 CLINTON AVE, NEWARK, NJ 07108-1004
(973) 373-0955
Mailing address
804 CLINTON AVE, NEWARK, NJ 07108-1004
(973) 373-0955
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
MD001857
NJ
Other
Enumeration date
01/25/2007
Last updated
09/21/2007
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