Individual
DR. NORA YOUSEFZADEH-GRUNIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
630 W 168TH ST, NEW YORK, NY 10032-3725
(212) 305-6912
(212) 305-5777
Mailing address
850 BOYLSTON ST, SUITE 560, CHESTNUT HILL, MA 02467-2477
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
244554-1
NY
2085R0202X
Diagnostic Radiology Physician
Primary
243651
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
243651
LICENSE
MA
01
—
244554-1
LICENSE
NY
Enumeration date
05/29/2008
Last updated
10/04/2011
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