Individual
SALLYE RENEE GRANBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
760 BROADWAY, BROOKLYN, NY 11206-5317
(718) 963-8136
Mailing address
1020 E 81ST ST, BROOKLYN, NY 11236-4222
(718) 513-4591
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
165224
NY
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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