Individual
MARY T GRANHOLM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN MSN APN
Contact information
Practice address
20 PROSPECT AVE, SUITE 400, HACKENSACK, NJ 07601-1997
(201) 336-8297
(201) 336-8296
Mailing address
26 TWIN LAKES DR, AIRMONT, NY 10952-4414
(845) 356-8777
Taxonomy
Speciality
Code
Description
License number
State
163WX0200X
Oncology Registered Nurse
Primary
26NJ00189400
NJ
Other
Enumeration date
06/25/2009
Last updated
06/25/2009
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