Basic Information
| Provider Information | |||||||||
| NPI: | 1821151481 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRANATO | ||||||||
| FirstName: | EDUARDO | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 28064 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100878064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9145937880 | ||||||||
| FaxNumber: | 9145937881 | ||||||||
| Practice Location | |||||||||
| Address1: | 3 MICHAEL FREY DR | ||||||||
| Address2: | |||||||||
| City: | EASTCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 107092725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9143373500 | ||||||||
| FaxNumber: | 9143373531 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/18/2006 | ||||||||
| LastUpdateDate: | 11/05/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 179085 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | A100000178 | 01 | NY | MEDICARE GROUP PTAN | OTHER | P00951941 | 01 | RAILROAD MEDICARE PTAN | OTHER |