EDITH GRANNUM MD PC (NPI# 1104003235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104003235 |
| Entity Type | Organization |
| Organization Name | EDITH GRANNUM MD PC |
| Practice Address |
1815 S Clinton Ave Rochester NY 14618-5720 |
| Mailing Address |
Po Box 18545 Rochester NY 14618-8545 |
| Practice Telephone | 5852331366 |
| Mailing Telephone | 5852331366 |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2008-03-19 |
| Authorized Official Name | DR. EDITH GWENDOLINE GRANNUM (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 5852331366 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 210929 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
1815 S CLINTON AVE |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14618-5720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225004476 | Nanette D Phillis, Md, Pllc | Internal Medicine | 1815 S Clinton Ave, Suite 340, Rochester, NY 14618-5720 | 2006-02-27 |
| 1952684748 | Valerie Lynn Pachuta | Nurse Practitioner | 1815 S Clinton Ave, Suite 530, Rochester, NY 14618-5720 | 2011-09-28 |
| 1306094198 | Timothy Patrick Smith | Physician Assistant | 1815 S Clinton Ave, Suite 530, Rochester, NY 14618-5720 | 2008-09-04 |
| 1477720415 | Stephen E Presser | Dermatology | 1815 S Clinton Ave, Suite 530, Rochester, NY 14618-5720 | 2008-05-09 |
| 1396961231 | James J Infantino | Dentist | 1815 S Clinton Ave, Rochester, NY 14618 | 2007-04-18 |
| 1144302027 | Stephen E Presser | Dermatology | 1815 S Clinton Ave, #530, Rochester, NY 14618-5720 | 2006-10-19 |
| 1790876886 | Janet R Casey | Pediatrics | 1815 S Clinton Ave, Ste 360, Rochester, NY 14618 | 2006-09-27 |
| 1427150655 | Joseph Lawrence Dulski | Dentist | 1815 S Clinton Ave, Ste 345, Rochester, NY 14618 | 2006-09-01 |
| 1528004223 | Timothy Lawrence | Psychiatry & Neurology | 1815 S Clinton Ave, Suite 445, Rochester, NY 14618-5720 | 2006-06-21 |
| 1740244649 | Mary Jo Spallina | Obstetrics & Gynecology | 1815 S Clinton Ave, Suite 610, Rochester, NY 14618-5720 | 2006-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962056499 | Zahavi Dental of Rochester | Dentist | 1815 S. Clinton Ave, 510, Rocheter, NY 14618 | 2019-08-01 |
| 1760047278 | Inner Power Physical Therapy Pllc | Clinic/Center | 2561 Lac Deville Boulevard, Suite 100, Rochester, NY 14618 | 2019-05-09 |
| 1659859858 | Steven Sanfilippo | Counselor | 2000 S. Winton Rd., Building 4, Suite 303, Rochester, NY 14618 | 2018-07-31 |
| 1578064853 | Feet First Inc | Durable Medical Equipment & Medical Supplies | 1900 Clinton Ave S Ste 5, Rochester, NY 14618 | 2018-02-22 |
| 1558805374 | Jennifer Virella | Social Worker | 2000 South Winton Road, Bldg 2, Rochester, NY 14618 | 2016-12-13 |
| 1235589300 | Andrew Cyrus Marcy | Nurse Practitioner | 95 Allens Creek Road Bld 1 Ste 306, Rochester, NY 14618 | 2016-06-20 |
| 1932561073 | Legacy Pediatrics | Pediatrics | 1815 South Clinton Avenue Ste 360, Rochester, NY 14618 | 2016-03-28 |
| 1790143105 | Marie Lynn Bieber | Dietitian, Registered | 919 Winton Rd S Ste 220, Rochester, NY 14618 | 2016-02-01 |
| 1720443096 | Brittany Rose Masetta | Marriage & Family Therapist | 2000 S Winton Rd, Bldg 4, Suite #200, Rochester, NY 14618 | 2015-12-30 |
| 1437543097 | Kathleen Skye Kemp | Internal Medicine | 2400 S Clinton Ave Ste G2, Rochester, NY 14618 | 2015-03-22 |
| Find all providers in zip 14618 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467090761 | Community Medical Services, PC | Family Medicine | Community Medical Services, PC, 39 Delevan Street, Rochester, NY 14605 | 2019-12-17 |
| 1699336511 | Ruth Archibald | Family Medicine | 6962 Cottonwood Ct Nw, Rochester, MN 55901-8835 | 2019-06-21 |
| 1982132635 | Stephanie Parvan | Family Medicine | 1100 Long Pond Rd Ste 250, Rochester, NY 14626-1186 | 2017-05-25 |
| 1659804169 | Natasha Vadera | Family Medicine | Highland Family Medicine 777 S Clinton Ave, Rochester, NY 14642-0001 | 2017-04-11 |
| 1467804203 | Izabela Teresa Subczynska | Family Medicine | 454 E Broad St Ste 100, Rochester, NY 14607-1724 | 2016-07-05 |
| 1720433345 | Jerry Kong | Family Medicine | 919 Westfall Rd Ste 100, Rochester, NY 14618-2628 | 2016-05-02 |
| 1619352051 | Lavanya Ravindran | Family Medicine | 89 Genesee St Bldg 3, Rochester, NY 14611 | 2015-07-28 |
| 1346628930 | Bohdan Klymochko | Family Medicine | 1300 Jefferson Rd Ste 100, Rochester, NY 14623 | 2015-05-14 |
| 1851705628 | Resika Ubayawardena | Family Medicine | 222 Alexander St, Ste 5000, Genesee Internal Medicine At Alexander Park, Rochester, NY 14607-4039 | 2014-06-19 |
| 1942613344 | Lishan Jhanealle Walker | Family Medicine | 10 S Pointe Lndg Ste 210, Rochester, NY 14606-3481 | 2014-06-04 |
| Find all providers in ROCHESTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.