Individual
CHRISTOPHER GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSED
Contact information
Practice address
5480 BROADWAY APT 10F, BRONX, NY 10463-7620
(917) 750-4634
Mailing address
5480 BROADWAY APT 10F, BRONX, NY 10463-7620
(917) 750-4634
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
01/21/2016
Last updated
01/21/2016
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