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Organization

GRACE MROZ NP IN PSYCHIATRY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GRACE MROZ (OWNER)
(631) 730-7503
Entity
Organization

Contact information

Practice address
450 WAVERLY AVE STE 11, PATCHOGUE, NY 11772-1555
(631) 730-7503
Mailing address
450 WAVERLY AVE STE 11, PATCHOGUE, NY 11772-1555

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
01/26/2019
Last updated
01/26/2019
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