Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 158670 | MA |
NPI | 1033245626 |
---|---|
Provider Name | John P Grandy |
First Address | Hockessin, DE 19707-2134 |
Second Address | Hockessin, DE 19707-2134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 08/07/2007 |