| NPI | 1811243496 |
|---|---|
| Doing Business As | GRAND STREET MEDICAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | AMJAD KHAN Billing Manager 845-338-1535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 123071-1) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 208411-1) |
| 207Q00000X Family Medicine (Licence: NY 238102-1) | |
| 207Q00000X Family Medicine (Licence: NY 238100-1) | |
| 207Q00000X Family Medicine (Licence: NY 233816-1) | |
| 207Q00000X Family Medicine (Licence: NY 154954) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 002092-1) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: NY 175032-1) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: NY 220158-1) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: NY 254731-1) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 171395-1) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 115320-1) | |
| 207W00000X Ophthalmology (Licence: NY 116416-1) | |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2012-08-01 |