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Individual

ANN D GRACER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
6724 165TH ST, FRESH MEADOWS, NY 11365-3204
(718) 463-4640
(718) 463-4655
Mailing address
6724 165TH ST, FRESH MEADOWS, NY 11365-3204
(718) 463-4640
(718) 463-4655

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
01778
NY
103TA0700X
Adult Development & Aging Psychologist
01778
NY
103TB0200X
Cognitive & Behavioral Psychologist
01778
NY
103TC0700X
Clinical Psychologist
01778
NY
103TH0100X
Health Service Psychologist
01778
NY
103TP0814X
Psychoanalysis Psychologist
01778
NY
103TP2701X
Group Psychotherapy Psychologist
Primary
01778
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01413547
NY
01
179302
MHN
NY
Enumeration date
09/15/2005
Last updated
09/11/2025
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