Provider Demographics
NPI:1619230190
Name:GRAND MERIDIAN, INC.
Entity Type:Organization
Organization Name:GRAND MERIDIAN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:PROF
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:N
Authorized Official - Last Name:LEUNG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:646-705-3656
Mailing Address - Street 1:209-211 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-5403
Mailing Address - Country:US
Mailing Address - Phone:212-965-1503
Mailing Address - Fax:
Practice Address - Street 1:209-211 GRAND ST.
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-5403
Practice Address - Country:US
Practice Address - Phone:212-965-1503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty