Mary T Granholm, RN MSN APN

Primary specialty

Oncology Registered NurseTaxonomy code 163WX0200X

License

26NJ00189400 Issued in NJ

Practice address

20 Prospect Ave
Suite 400
Hackensack, NJ 07601-1997

Phone

(201) 336-8297

Fax

(201) 336-8296

NPI assigned

Jun 25, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Valley Physician Services PC

  • Internal Medicine Physician
  • Paramus, NJ
  • NPI 1467815928
  Medicare reassignment NPD

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245888000000",
    "number": "1861620155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 TWIN LAKES DR",
            "city": "AIRMONT",
            "state": "NY",
            "postal_code": "109524414",
            "telephone_number": "845-356-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE",
            "address_2": "SUITE 400",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011997",
            "telephone_number": "201-336-8297",
            "fax_number": "201-336-8296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANHOLM",
        "first_name": "MARY",
        "middle_name": "T",
        "credential": "RN MSN APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2009-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "NJ",
            "license": "26NJ00189400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Total Homecare Services LLC.
• Briel Gradinger, PT,DPT
• Deena Mary Atieh Graham, M.D.
• Heather Graham, P.T.
• Anthony Grand, PA-C
• Luis C Grau, MD
• Richard Yackshaw Greco, D.O.
• Sandra Rose Green, MEDICAL TRANSPORT
• Annie Greenberg, PT
• Sabrina Greenfield

• Oncology Registered Nurse in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Oncology Registered Nurse in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; 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.