Individual
MS. SUZANNE GRIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
9 N CLINTON AVE, BAY SHORE, NY 11706-7821
(631) 665-5873
Mailing address
811 PINE AVE, WEST ISLIP, NY 11795-2720
(631) 383-5976
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
802374
NY
Other
Enumeration date
03/09/2022
Last updated
03/09/2022
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