Granitsas, Joan
Granitsas, Joan is an individual health care provider with primary practice located at 280 Beach St , Revere MA 02151-3143. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Granitsas, Joan can be contacted via phone (781) 289-5057.Contact Information
Primary practice address
280 Beach St
Revere MA 02151-3143
Phone: (781) 289-5057
Fax: (781) 289-4485
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 214641 | Massachusetts |
Profile Details
| NPI number | 1215934070 |
|---|---|
| LBN Legal business name | Granitsas, Joan |
| Credentials | CRNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 7th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215934070 | NPPES |
| Massachusetts | MEDICAID | 0350231 | |
| Massachusetts | Other | NP9820 |
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