Grannum, Edith

Grannum, Edith is an individual health care provider with primary practice located at 1815 Clinton Ave S Ste 330 , Rochester NY 14618-5717. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Grannum, Edith can be contacted via phone (585) 461-6004.

Contact Information

Primary practice address
1815 Clinton Ave S Ste 330 Rochester NY 14618-5717
Phone: (585) 461-6004
Fax: (585) 461-6009
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 210929 New York

Profile Details

NPI number 1821060237
LBN Legal business name Grannum, Edith
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2006
Last updated Jun 21st, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821060237 NPPES
New York MEDICAID 01894408

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