Bryan F Granelli, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

SI1942 Issued in NJ

Practice address

14-25 Plaza Rd Ste N27
Fair Lawn, NJ 07410-3548

Phone

(201) 445-4310

NPI assigned

Dec 19, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1801950639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14-25 PLAZA RD STE N27",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103548",
            "telephone_number": "201-445-4310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14-25 PLAZA RD STE N27",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103548",
            "telephone_number": "201-445-4310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Prospect St",
            "address_purpose": "LOCATION",
            "city": "Ridgewood",
            "state": "NJ",
            "postal_code": "074504489",
            "country_code": "US",
            "telephone_number": "201-445-4310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANELLI",
        "first_name": "BRYAN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "SI1942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gotlieb Hearing Center
• Gotlieb Hearing Center Limited Liability Company
• Talia Gotlieb, MA, CCC-A
• Nicole E. Grace, LCSW, PSYA
• Thomas Charles Grace, PSY.D.
• Robert Greenblum, MD
• Sarah Gregor, LSW
• James Grochowski, BCBA
• Lisa Groner, P.T.
• Steven Grossman, MD, FACC

• Psychologist in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.