Provider Demographics
NPI:1649733908
Name:GRALNICK, ROBERT HOWARD
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:HOWARD
Last Name:GRALNICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 EASTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44124-1522
Mailing Address - Country:US
Mailing Address - Phone:440-591-2440
Mailing Address - Fax:
Practice Address - Street 1:1345 EASTWOOD AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44124-1522
Practice Address - Country:US
Practice Address - Phone:440-591-2440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist