Provider Demographics
NPI:1891759858
Name:DIGRANDI, SALVATORE J (MD)
Entity Type:Individual
Prefix:
First Name:SALVATORE
Middle Name:J
Last Name:DIGRANDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:198 ROUTE 22
Practice Address - Street 2:
Practice Address - City:PAWLING
Practice Address - State:NY
Practice Address - Zip Code:12564-3241
Practice Address - Country:US
Practice Address - Phone:845-855-5536
Practice Address - Fax:845-855-0843
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173611-1207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01604599Medicaid
NYA400022918Medicare PIN
NY01604599Medicaid
NY98K18EY751Medicare PIN