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Individual

GRACE NASRI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
61 DELANO ST, PULASKI, NY 13142-1400
(315) 298-6564
Mailing address
61 DELANO ST, PULASKI, NY 13142-1400
(315) 298-6564

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01092964A
IN
207Q00000X
Family Medicine Physician
Primary
311244
NY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/29/2018
Last updated
07/19/2024
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