Provider Demographics
NPI:1437123247
Name:GRANOWETTER, LINDA (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:GRANOWETTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 EAST 32ND STREET
Mailing Address - Street 2:HASSENFELD CENTER L3
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-263-9660
Mailing Address - Fax:212-263-8410
Practice Address - Street 1:160 EAST 32ND STREET
Practice Address - Street 2:HASSENFELD CENTER L3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-263-9660
Practice Address - Fax:212-263-8410
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY17210442080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01052639Medicaid
NY01052639Medicaid
NYA60722Medicare UPIN