Individual
MRS. THELMA B GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1323 TANWOOD DR., BALDWIN, NY 11510
(516) 546-8516
Mailing address
1323 TANWOOD DRIVE, BALDWIN, NY 11510
(516) 546-8516
(516) 546-0030
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
F000025
NY
363LP2300X
Primary Care Nurse Practitioner
F360293
NY
Other
Enumeration date
12/03/2012
Last updated
12/03/2012
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