Individual
MS. GERALDINE DESGRAVIERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
89 S 25TH ST, WYANDANCH, NY 11798-2905
(631) 575-7260
Mailing address
88 W FARM DR, MELVILLE, NY 11747-4153
(631) 575-7260
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
624105
NY
Other
Enumeration date
09/20/2011
Last updated
09/20/2011
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