Individual
MARK ALAN GRAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
447 ATLANTIC AVE, BROOKLYN, NY 11217-1702
(718) 858-6300
(718) 858-0145
Mailing address
55 WATER ST, 12TH FLOOR - CREDENTIALING, NEW YORK, NY 10041-0004
(646) 680-2888
(516) 542-5556
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1539331
NY
207RH0000X
Hematology (Internal Medicine) Physician
153933
NY
207RX0202X
Medical Oncology Physician
Primary
153933
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00927284
—
NY
Enumeration date
06/12/2006
Last updated
09/12/2019
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