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Individual

SERENA GRAINGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
EMT-B

Contact information

Practice address
3677 RIVER RD, YOUNGSTOWN, NY 14174-9700
(716) 628-0496
Mailing address
3677 RIVER RD, YOUNGSTOWN, NY 14174-9700
(716) 628-0496

Taxonomy

Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
431762
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
431762
EMT
NY
Enumeration date
08/05/2017
Last updated
08/05/2017
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