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Individual

MRS. GRACY SEBASTIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
30 CREST DR, WHITE PLAINS, NY 10607-2718
(609) 540-2483
Mailing address
30 CREST DR, WHITE PLAINS, NY 10607-2718
(609) 540-2483

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9520088
NY
363LF0000X
Family Nurse Practitioner
F341159-1
NY

Other

Enumeration date
08/07/2017
Last updated
08/07/2017
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