Individual
TANEISHA GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8 DEVINE ST, NORTH HAVEN, CT 06473-2172
(877) 925-3637
Mailing address
20 YORK ST, NEW HAVEN, CT 06510-3220
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
50764
CT
Other
Enumeration date
12/09/2007
Last updated
10/19/2023
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