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Individual

MS. CAROL A GRANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1 BAY AVE, MONTCLAIR, NJ 07042-4837
(973) 429-6275
Mailing address
1305 WALT WHITMAN RD STE 300, MELVILLE, NY 11747-4300
(516) 370-3861
(973) 762-4639

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
NO07563700
NJ
367500000X
Certified Registered Nurse Anesthetist
Primary
26NJ00193000
NJ

Other

Enumeration date
02/22/2007
Last updated
10/08/2024
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