Individual
MISS ANDREA THERESA GROVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
164 PENNSYLVANIA AVE, BROOKLYN, NY 11207-3046
(347) 787-1045
Mailing address
13918 232ND ST, LAURELTON, NY 11413-2927
(917) 767-4304
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
240710-1
NY
Other
Enumeration date
05/07/2008
Last updated
05/07/2008
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