Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | P6280 | TX |
Y | 2080P0214X | Pediatric Pulmonologist | 263123 | NY |
NPI | 1609155340 |
---|---|
Provider Name | Dr. Chantal Y Grant |
First Address | New York, NY 10029 |
Second Address | New York, NY 10029-6504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2011 |
Last Update Date | 14/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
080462703 | (05) | TX |