T Grant Phd | |
257 Main St New Paltz NY 12561-1610 | |
(845) 256-9528 | |
(845) 256-9528 |
Full Name | T Grant Phd |
---|---|
Speciality | Psychologist |
Location | 257 Main St, New Paltz, New York |
Authorized Official Name and Position | Thomas H Grant (CLINICAL PSYCHOLOGIST) |
Authorized Official Contact | 8452569528 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
T Grant Phd 257 Main St New Paltz NY 12561-1610 Ph: (845) 256-9528 | T Grant Phd 257 Main St New Paltz NY 12561-1610 Ph: (845) 256-9528 |
NPI Number | 1215211719 |
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Provider Enumeration Date | 10/03/2011 |
Last Update Date | 10/03/2011 |
Medicare PECOS PAC ID | 8224203005 |
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Medicare Enrollment ID | O20111206000298 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215211719 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 011779 (New York) | Primary |
Provider Name | Thomas H Grant |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1437236247 PECOS PAC ID: 5496920274 Enrollment ID: I20111206000364 |
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