Individual
DR. MICHAEL JOHN GRAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
1190 TROY SCHENECTADY RD, LATHAM, NY 12110-1026
(518) 469-3110
Mailing address
952 TROY SCHENECTADY RD, SUITE 267, LATHAM, NY 12110-1608
(518) 469-3110
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
013600
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11324536
CAQH
NY
Enumeration date
11/21/2006
Last updated
09/11/2007
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