Provider Demographics
NPI:1114268224
Name:NATALIE GRANT
Entity Type:Organization
Organization Name:NATALIE GRANT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTRED NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:646-483-1162
Mailing Address - Street 1:5812 FARRAGUT RD
Mailing Address - Street 2:BROOKLYN NY 11234 APT 2B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-1353
Mailing Address - Country:US
Mailing Address - Phone:164-648-3112
Mailing Address - Fax:
Practice Address - Street 1:5812 FARRAGUT RD
Practice Address - Street 2:BROOKLYN NEW YORK APT 2B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-1353
Practice Address - Country:US
Practice Address - Phone:646-483-1162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care