MARK GRANICK (NPI# 1235239328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235239328 |
| Entity Type | Individual |
| Full Name | MARK GRANICK |
| Credential | MD |
| Practice Address |
140 Bergen Street E 1620 Newark NJ 19103 |
| Mailing Address |
6 Westmount Dr Livingston NJ 07039-4213 |
| Practice Telephone | 9739728092 |
| Mailing Telephone | 9739728092 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2082S0099X |
Plastic Surgery Specialization: Plastic Surgery Within the Head and Neck |
MA72027 | NJ | Allopathic & Osteopathic Physicians |
| X | 2082S0105X |
Plastic Surgery Specialization: Surgery of the Hand |
MA72027 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 6762409 | 05 |
| Street Address |
140 BERGEN STREET E 1620 |
| City | NEWARK |
| State | NJ |
| Zip Code | 19103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565431 | Allyson Caputa | Behavior Technician | 100 North 18th Street, Suite 300, Philadelphia, PA 19103 | 2020-10-13 |
| 1063062685 | Sarah Seeling | Social Worker | 255 South 17th Street Suite 1010, Suite 1500, Suite 23, Philadelphia, PA 19103 | 2019-09-16 |
| 1730735051 | Jill Verofsky | Counselor | 1180 Jfk Blvd, Suite 1110, Philadelphia, PA 19103 | 2019-08-13 |
| 1932761863 | Barclay Prescription Pharmacy | Pharmacist | 1736 Spruce St, Phila, PA 19103 | 2019-07-01 |
| 1265910459 | Whitney Sue Fricke | Counselor | 2211 Locust St, Philadelphia, PA 19103 | 2018-07-31 |
| 1740784586 | Sara Elizabeth Macintyre | Speech-Language Pathologist | 1845 Walnut Street Suite 1540, Philadelphia, PA 19103 | 2018-03-19 |
| 1326578907 | Danielle D Bercovitch | Speech-Language Pathologist | 1930 S Broad, Philadelphia, PA 19103 | 2017-06-15 |
| 1598114449 | Brooke Elaine Mullen | Dietitian, Registered | 1708 Pine St Apt 1r, Philadelphia, PA 19103 | 2016-06-10 |
| 1972966026 | Alexandra Brady Jatzke | Dietitian, Registered | 1835 Market St Fl 2, Philadelphia, PA 19103 | 2016-04-05 |
| 1932574118 | David Clements Iv | Psychiatry & Neurology | 1845 Walnut St Ste 1540, Philadelphia, PA 19103 | 2015-12-14 |
| Find all providers in zip 19103 | ||||
| Taxonomy Code | 2082S0099X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| Specialization | Plastic Surgery Within the Head and Neck |
| A plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgery is practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. A subspecialty certificate was approved by the ABMS in 2000. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669476164 | Paul Sabini | Plastic Surgery | 537 Stanton Christiana Rd, Suite # 107, Newark, DE 19713-2146 | 2005-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437470895 | Dr Goodnight Center for Everlasting Beauty | Plastic Surgery | 535 High Mountain Rd, Suite 110, North Haledon, NJ 07508-2665 | 2010-06-18 |
| 1316278658 | Aesthetic and Reconstructive Therapies LLC | Plastic Surgery | 1 W Ridgewood Ave, Suite 302, Paramus, NJ 07652-2359 | 2010-01-27 |
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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.