Individual
ASIA SHANTE GRISSETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
517 ROCKLAND ST, WESTBURY, NY 11590-3407
(347) 930-8163
Mailing address
517 ROCKLAND ST, WESTBURY, NY 11590-3407
(347) 930-8163
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
337555
NY
Other
Enumeration date
01/06/2020
Last updated
01/06/2020
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