Basic Information
| Provider Information | |||||||||
| NPI: | 1508838202 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GRANATO | ||||||||
| FirstName: | ANTHONY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 WESCOTT DR | ||||||||
| Address2: | SUITE G2 | ||||||||
| City: | FLEMINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088224600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082371560 | ||||||||
| FaxNumber: | 9088062529 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 WESCOTT DR | ||||||||
| Address2: | SUITE 107 | ||||||||
| City: | FLEMINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088224600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082371148 | ||||||||
| FaxNumber: | 9082371318 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2006 | ||||||||
| LastUpdateDate: | 08/03/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | MA07388500 | NJ | Y | Other Service Providers | Specialist |
No ID Information.