DIANE TACKIE GRANILLO, LLC

Physician Assistant - Medical

Active Organization
NPI: 1972393171

Practice Address

40 YORK RD STE 110
Towson, MD 21204

Phone: (202) 951-7942

Specialties

Specialty Code Primary License
Physician Assistant - Medical 363AM0700X Yes -

Frequently Asked Questions

NPI 1972393171 is the National Provider Identifier for DIANE TACKIE GRANILLO, LLC, a Physician Assistant - Medical provider located in Towson, MD. This NPI was enumerated on May 9, 2025.

Quick Facts

NPI
1972393171
Type
Organization
Enumerated
May 9, 2025
Last Updated
Oct 7, 2025

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