Individual
GRACE BLAIR CONDORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
17505 HORACE HARDING EXPY, FRESH MEADOWS, NY 11365-1535
(718) 990-8417
Mailing address
6 WOODLAND AVE, PORT CHESTER, NY 10573-2947
(914) 934-1442
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
NY
Other
Enumeration date
08/30/2022
Last updated
08/30/2022
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