Individual
MS. ALIE THERESA MASSICOT-GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
451 CLARKSON AVE, BROOKLYN, NY 11203-2054
(718) 245-2000
Mailing address
451 CLARKSON AVE, BROOKLYN, NY 11203-2054
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F336532-1
NY
Other
Enumeration date
03/01/2012
Last updated
04/05/2012
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