Individual
YANNERY GRULLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17 WINTHROP AVE, MIDDLETOWN, NY 10940-6017
(347) 498-5309
Mailing address
17 WINTHROP AVE, MIDDLETOWN, NY 10940-6017
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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