Individual
MR. RICHARD ALEXANDER GROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
3709 20TH RD, ASTORIA, NY 11105-1624
(347) 531-0987
Mailing address
3709 20TH RD, ASTORIA, NY 11105-1624
(347) 531-0987
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
701891
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
403406
NY
Other
Enumeration date
04/08/2018
Last updated
02/25/2022
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