Individual
DR. GLEN THOMAS GRANATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
MATHER HOSPITAL, 75 N COUNTRY RD, PORT JEFFERSON, NY 11777
(631) 473-1320
Mailing address
MATHER HOSPITAL, 75 NORTH COUNTRY RD, INTENSIVIST DEPARTMENT, PORT JEFFERSON, NY 11777
(631) 473-1320
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
302485
NY
207RP1001X
Pulmonary Disease Physician
302485
NY
Other
Enumeration date
04/24/2014
Last updated
09/10/2020
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