Basic Information
Provider Information
NPI: 1437135746
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GRANO
FirstName: VANESSA
MiddleName: ALEXY
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 210 WESTCHESTER AVE
Address2: 3RD FLOOR
City: WHITE PLAINS
State: NY
PostalCode: 106042901
CountryCode: US
TelephoneNumber: 9146813146
FaxNumber: 9146824603
Practice Location
Address1: 1 THEALL RD
Address2:  
City: RYE
State: NY
PostalCode: 105801404
CountryCode: US
TelephoneNumber: 9148488800
FaxNumber: 9146826403
Other Information
ProviderEnumerationDate: 12/19/2005
LastUpdateDate: 10/16/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X187889NYY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207V00000X038675CTN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

ID Information
IDTypeStateIssuerDescription
187889-101NYWORKERS COMPENSATIONOTHER
13388416801NYEMPIRE STATE PLAN (NYS)OTHER
434513301NYAETNA NON HMOOTHER
0131442905NY MEDICAID
029688001NYGHI PPOOTHER
0D326601NYHEALTH NETOTHER
13388416801NYPHCSOTHER
13388416801NYPOMCOOTHER
374594601NYAETNA HMOOTHER
WP30701NYOXFORDOTHER
051003401NYCIGNAOTHER
118915001NYUNITED HEALTH CAREOTHER
13388416801NYHORIZON HEALTHCARE OF NYOTHER
13388416801NYMULTIPLANOTHER
18788901NYCONNECTICAREOTHER
13388416801NYBEECH STREETOTHER
761E62/761E6101NYBLUE CROSS DELUXEOTHER


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