Organization
CHARLES E. GRANATIR, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES E GRANATIR MD (PHYSICIAN)
(201) 997-7667
Entity
Organization
Contact information
Practice address
586 KEARNY AVE, KEARNY, NJ 07032-2806
(201) 997-7667
(201) 997-3324
Mailing address
586 KEARNY AVE, KEARNY, NJ 07032-2806
(201) 997-7667
(201) 997-3324
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA047062
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
518001
MEDICARE PROVIDER
NJ
Enumeration date
10/30/2008
Last updated
07/20/2015
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