Provider Demographics
NPI:1821151481
Name:GRANATO, EDUARDO S (MD)
Entity Type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:S
Last Name:GRANATO
Suffix:
Gender:M
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:PO BOX 28064
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-8064
Mailing Address - Country:US
Mailing Address - Phone:914-593-7880
Mailing Address - Fax:914-593-7881
Practice Address - Street 1:3 MICHAEL FREY DR
Practice Address - Street 2:
Practice Address - City:EASTCHESTER
Practice Address - State:NY
Practice Address - Zip Code:10709-2725
Practice Address - Country:US
Practice Address - Phone:914-337-3500
Practice Address - Fax:914-337-3531
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179085207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100000178OtherMEDICARE GROUP PTAN
P00951941OtherRAILROAD MEDICARE PTAN
NYA100000178OtherMEDICARE GROUP PTAN
P00951941OtherRAILROAD MEDICARE PTAN
NYA100000178OtherMEDICARE GROUP PTAN