Individual
DR. LAUREN ROSE GRANATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101242984
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10032520
OPTIMA
VA
01
—
139178
BCBS
VA
05
—
5910265
—
NC
01
—
P00616142
RR MEDICARE
VA
Enumeration date
11/21/2006
Last updated
02/07/2014
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