Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 011465 | NY |
NPI | 1801071527 |
---|---|
Provider Name | Dr. Graig V Granovsky |
First Address | Brooklyn, NY 11229-1249 |
Second Address | Brooklyn, NY 11229-1249 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2007 |
Last Update Date | 02/05/2008 |