Provider Demographics
NPI:1124079322
Name:GRANT, ERIN (CA)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:
Last Name:GRANT
Suffix:
Gender:F
Credentials:CA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:205 NARRAGANSETTE AVE # 536
Mailing Address - Street 2:
Mailing Address - City:OCEAN GATE
Mailing Address - State:NJ
Mailing Address - Zip Code:08740-1365
Mailing Address - Country:US
Mailing Address - Phone:732-600-7467
Mailing Address - Fax:609-693-4480
Practice Address - Street 1:769 ROUTE 9 STE 6
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08721-2540
Practice Address - Country:US
Practice Address - Phone:732-600-7467
Practice Address - Fax:732-269-9630
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171100000X
NJMZ000103171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist