| Doctor Name: | GRANT MARSHALL MYERS |
| NPI Number: | 1003158502 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PMHNP-BC |
| License Number: | 26NJ00419200 |
| Business Practice Address: | 830 Bear Tavern Rd Ewing, NJ - 086281020 |
| Business Phone Number: | 8003703651 |
| Business Fax Number: | 8605100020 |
| Mailing Address: | 20 Research Pkwy, OLD SAYBROOK |
| State: | CT |
| Postal Code: | 064754214 |
| Phone Number: | 8003703651 |
| Fax Number: | 8605100020 |
| NPI Enumeration Date: | 03/22/2013 |
| NPI Last Update Date: | 04/29/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 26NJ00419200 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |