Keriann Grandazza
Specialist in Melville, NY. Individual provider (NPI-1).
NPI number1164091666
StatusActive
Last updated in NPPESJun 21, 2021
Details
- NPI
- 1164091666
- Entity type
- Individual (NPI-1)
- Name
- Keriann Grandazza
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 21, 2021
- Certification date
- Jun 21, 2021
- Last updated
- Jun 21, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
Practice location
225 Broadhollow Rd Ste 402Melville, NY 11747-4899
Phone 631-385-7780
Mailing address
15 Oak StRockville Centre, NY 11570-5009
Phone 516-404-0764
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