Provider Demographics
NPI:1255414876
Name:GRANIRER, LOUIS T (DC)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:T
Last Name:GRANIRER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 WALL ST STE 7
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-8001
Mailing Address - Country:US
Mailing Address - Phone:845-334-0853
Mailing Address - Fax:
Practice Address - Street 1:307 WALL ST STE 7
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-8001
Practice Address - Country:US
Practice Address - Phone:845-334-0853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010088-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX8F841Medicare PIN