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Individual

MRS. GRACE IVEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP, RN

Contact information

Practice address
6111 QUEENS BLVD, WOODSIDE, NY 11377-4965
(718) 205-0287
Mailing address
6111 QUEENS BLVD, WOODSIDE, NY 11377-4965
(718) 205-0287

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
643179
NY
363LF0000X
Family Nurse Practitioner
Primary
F349788
NY

Other

Enumeration date
12/05/2012
Last updated
01/06/2026
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