Individual
MISS CAITLIN M GRANAURO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3 WADE DR, LAKE GROVE, NY 11755-2324
(631) 585-2506
Mailing address
3 WADE DR, LAKE GROVE, NY 11755-2324
(631) 585-2506
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
151826015
NY
Other
Enumeration date
09/03/2012
Last updated
09/03/2012
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