Provider Demographics
NPI:1548592819
Name:GRINMAN, MICHAEL (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:GRINMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6537
Mailing Address - Country:US
Mailing Address - Phone:718-424-0100
Mailing Address - Fax:718-424-5044
Practice Address - Street 1:7501 37TH AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6537
Practice Address - Country:US
Practice Address - Phone:718-424-0100
Practice Address - Fax:718-424-5044
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053247183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist