Individual provider · Type 1 NPI
Mary T. Granholm, RN MSN APN
Oncology Registered Nurse · Hackensack, NJ
NPI number
1861620155
Active
Practice location
20 Prospect Ave, Suite 400
Hackensack, NJ 07601-1997
Fax (201) 336-8296
Mailing address
26 Twin Lakes Dr
Airmont, NY 10952-4414
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Oncology Registered Nurse Primary | 163WX0200X | 26NJ00189400 (NJ) |
Oncology Registered Nurse: Definition to come...
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About NPI 1861620155
Mary T. Granholm, RN MSN APN's National Provider Identifier is 1861620155, issued on Jun 25, 2009. The primary taxonomy on file is Oncology Registered Nurse (163WX0200X), and the practice location is in Hackensack, NJ. The record was last updated on Jun 25, 2009.