Individual
GRACE STFORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10 GRAND ARMY PLZ, BROOKLYN, NY 11238-5600
(718) 230-2100
Mailing address
10 GRAND ARMY PLZ, BROOKLYN, NY 11238-5600
(718) 230-2100
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
1548800642
NY
Other
Enumeration date
01/26/2024
Last updated
01/26/2024
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