Provider Demographics
NPI:1750305678
Name:GRANT, LINDA F (MD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:F
Last Name:GRANT
Suffix:
Gender:F
Credentials:MD
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5 PERRYRIDGE RD
Mailing Address - Street 2:PHYSICAL MEDICINE & REHABILITATION
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-4608
Mailing Address - Country:US
Mailing Address - Phone:203-863-3292
Mailing Address - Fax:203-863-4590
Practice Address - Street 1:5 PERRYRIDGE RD
Practice Address - Street 2:PHYSICAL MEDICINE & REHABILITATION
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-4608
Practice Address - Country:US
Practice Address - Phone:203-863-3292
Practice Address - Fax:203-863-4590
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT029757208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
E36898Medicare UPIN
CT130000301Medicare ID - Type Unspecified