Provider Demographics
NPI:1437516663
Name:GRANIK, JOEL (LAC)
Entity type:Individual
Prefix:MR
First Name:JOEL
Middle Name:
Last Name:GRANIK
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 W 56TH ST
Mailing Address - Street 2:FIFTH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-3906
Mailing Address - Country:US
Mailing Address - Phone:212-600-0220
Mailing Address - Fax:
Practice Address - Street 1:39 W 56TH ST
Practice Address - Street 2:FIFTH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3906
Practice Address - Country:US
Practice Address - Phone:212-600-0220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005688171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist