Individual
MRS. JENNIFER ANNE GRELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN,BC
Contact information
Practice address
363 ROUTE 111, SUITE 101, SMITHTOWN, NY 11787-4756
(631) 724-8075
(631) 724-8076
Mailing address
25 ASTER AVE, HOLTSVILLE, NY 11742-1733
(631) 207-2262
(631) 207-2262
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F303036-1
NY
Other
Enumeration date
09/14/2006
Last updated
08/18/2008
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