Charles Frederick Grannum
Prosthodontist
1536 Bedford Ave
Brooklyn
, New York 11216-4117
Charles Frederick Grannum
Prosthodontist
1536 Bedford Ave
Brooklyn
, New York 11216-4117
(800) 376-5566
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About
Features
Specialties
- Prosthodontist
Languages spoken
- English
Location
First Address
- Charles Frederick Grannum
- Po Box 29889
- New York, NY
- Zip : 10087-9889
- Phone : (800) 376-5566
Second Address
- Charles Frederick Grannum
- 1536 Bedford Ave
- Brooklyn, NY
- Zip : 11216-4117
- Phone : (800) 376-5566
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0700X | Prosthodontist | 040024 | NY |
National Provider Identifier
| NPI | 1205904208 |
|---|---|
| Provider Name | Charles Frederick Grannum |
| First Address | New York, NY 10087-9889 |
| Second Address | Brooklyn, NY 11216-4117 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/11/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 040024 | LICENSE (01) | NY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.