Granich, Russ D.
Granich, Russ D. is an individual health care provider with primary practice located at 139 Toddy Hill Rd , Sandy Hook CT 06482-1362. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Granich, Russ D. can be contacted via phone (607) 303-9318.Contact Information
Primary practice address
139 Toddy Hill Rd
Sandy Hook CT 06482-1362
Phone: (607) 303-9318
Fax: (607) 303-9372
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207QG0300X | G50400 | California |
| Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine | 207QH0002X | 067712 | Connecticut |
| Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine | 207QH0002X | G50400 | California |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | G50400 | California |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 067712 | Connecticut |
Profile Details
| NPI number | 1962580589 |
|---|---|
| LBN Legal business name | Granich, Russ D. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 1st, 2006 |
| Last updated | Apr 13th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962580589 | NPPES |
| California | MEDICAID | 00G504000 |
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