Individual
MRS. GLORIA SOPHIA BEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRPA
Contact information
Practice address
770 GRAND BLVD, DEER PARK, NY 11729-5750
(631) 392-4357
Mailing address
770 GRAND BLVD, DEER PARK, NY 11729-5750
(631) 392-4357
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CRPA-5838
NY
Other
Enumeration date
05/10/2024
Last updated
05/10/2024
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