Individual
GLADYS KNOWLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3251 ROUTE 112, MEDFORD, NY 11763-1446
(631) 451-6007
(631) 297-8121
Mailing address
3251 ROUTE 112, MEDFORD, NY 11763-1446
(631) 451-6007
(631) 297-8121
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6812
NY
Other
Enumeration date
01/29/2014
Last updated
01/29/2014
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