Individual
MICHELE L DEGRAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
HSC T15-040, STONY BROOK, NY 11794-4413
(631) 638-0910
(631) 638-0915
Mailing address
PO BOX 1554, STONY BROOK, NY 11790-0988
(631) 444-0650
(631) 638-4170
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F306689-1
NY
Other
Enumeration date
01/20/2014
Last updated
10/27/2017
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