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Organization

GRACE MROZ NP IN PSYCHIATRY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GRACE MROZ (OWNER)
(631) 730-7503
Entity
Organization

Contact information

Practice address
450 WAVERLY AVE, BUILDING 4 SUITE 11, PATCHOGUE, NY 11772
(631) 730-7503
(631) 307-9422
Mailing address
450 WAVERLY AVE, BUILDING 4 SUITE 11, PATCHOGUE, NY 11772
(631) 730-7503
(631) 307-9422

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary

Other

Enumeration date
04/04/2019
Last updated
04/04/2019
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