Provider Demographics
NPI:1689785099
Name:GRANATO, TANYA LYNN
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:LYNN
Last Name:GRANATO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER
Mailing Address - State:NY
Mailing Address - Zip Code:12144
Mailing Address - Country:US
Mailing Address - Phone:518-935-4318
Mailing Address - Fax:518-459-9148
Practice Address - Street 1:334 KRUMKILL RD
Practice Address - Street 2:
Practice Address - City:SLINGERLANDS
Practice Address - State:NY
Practice Address - Zip Code:12159
Practice Address - Country:US
Practice Address - Phone:518-935-4318
Practice Address - Fax:518-459-9148
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor