Individual
RICHARD V GRENTZENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
830 HARRISON AVENUE, SUITE 1400, BOSTON, MA 02118
(617) 638-8124
(617) 638-6424
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
30440
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110035935A
—
MA
Enumeration date
04/10/2006
Last updated
04/16/2014
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