Doctor Name: | MARTHA S GRAYSON |
NPI Number: | 1033210661 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 143595 |
Business Practice Address: | 170 W 12th St Medicine/ General New York, NY - 100118202 |
Business Phone Number: | 2123564474 |
Business Fax Number: | 2123564608 |
Mailing Address: | 450 W 33rd St, Pbs 12th Floor NEW YORK |
State: | NY |
Postal Code: | 100012603 |
Phone Number: | 2123564474 |
Fax Number: | 2123564608 |
NPI Enumeration Date: | 09/26/2006 |
NPI Last Update Date: | 03/29/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 143595 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |