Active NPI
Danielle Marie Grandner, PA
- Physician Assistant
- Staten Island, NY
National Provider Identifier
1053371591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 010866
- Practice address
- 27 New Dorp LN
Staten Island, NY 10306-2349 - Phone
- (718) 667-3800
- NPI assigned
- Mar 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 010866 | NY | Primary |
Addresses
Primary practice location
27 New Dorp LN
Staten Island, NY 10306-2349
Mailing address
326 Peter Ave
Side Apt
Staten Island, NY 10306
Phone (718) 873-5574
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010866 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301443200000",
"number": "1053371591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "326 PETER AVE",
"address_2": "SIDE APT",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "10306",
"telephone_number": "718-873-5574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27 NEW DORP LN",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103062349",
"telephone_number": "718-667-3800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANDNER",
"first_name": "DANIELLE",
"middle_name": "MARIE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-27",
"last_updated": "2011-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "010866",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.