Individual
DR. OLGICA LABAN GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
333 WESTCHESTER AVE, SUITE E104, WHITE PLAINS, NY 10604-2910
(914) 428-9213
(914) 428-9282
Mailing address
690 N BROADWAY, SUITE GL1, WHITE PLAINS, NY 10603-2417
(914) 428-3651
(914) 428-2948
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
240414M60
NJ
2084N0600X
Clinical Neurophysiology Physician
049506
CT
2084N0600X
Clinical Neurophysiology Physician
2218321
NY
2084N0600X
Clinical Neurophysiology Physician
25MA07767500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0045675
—
NJ
05
—
02583333
—
NY
Enumeration date
01/11/2006
Last updated
07/16/2014
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