Individual
GRACE SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
26901 76TH AVE, NEW HYDE PARK, NY 11040-1433
(718) 470-7380
Mailing address
171 KILBURN RD S, GARDEN CITY SOUTH, NY 11530-5628
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F353468
NY
Other
Enumeration date
01/06/2025
Last updated
01/06/2025
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