Provider Demographics
NPI:1437135746
Name:GRANO, VANESSA ALEXY (MD)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:ALEXY
Last Name:GRANO
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 1:210 WESTCHESTER AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2901
Mailing Address - Country:US
Mailing Address - Phone:914-681-3146
Mailing Address - Fax:914-682-4603
Practice Address - Street 1:1 THEALL RD
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-1404
Practice Address - Country:US
Practice Address - Phone:914-848-8800
Practice Address - Fax:914-682-6403
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY187889207V00000X
CT038675207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY187889-1OtherWORKERS COMPENSATION
NY133884168OtherEMPIRE STATE PLAN (NYS)
NY4345133OtherAETNA NON HMO
NY01314429Medicaid
NY0296880OtherGHI PPO
NY0D3266OtherHEALTH NET
NY133884168OtherPHCS
NY133884168OtherPOMCO
NY3745946OtherAETNA HMO
NYWP307OtherOXFORD
NY0510034OtherCIGNA
NY1189150OtherUNITED HEALTH CARE
NY133884168OtherHORIZON HEALTHCARE OF NY
NY133884168OtherMULTIPLAN
NY187889OtherCONNECTICARE
NY133884168OtherBEECH STREET
NY761E62/761E61OtherBLUE CROSS DELUXE
CT160002246/C03316Medicare PIN
NY0D3266OtherHEALTH NET
NY187889-1OtherWORKERS COMPENSATION