| 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 |
|---|---|
| Provider Enumeration Date | 10/03/2011 |
| Last Update Date | 10/03/2011 |
| Medicare PECOS PAC ID | 8224203005 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437236247 PECOS PAC ID: 5496920274 Enrollment ID: I20111206000364 |
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