Individual
ANALYSSA GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
108 BURCHARD AVE, EAST ORANGE, NJ 07017-1620
(347) 623-9115
Mailing address
108 BURCHARD AVE, EAST ORANGE, NJ 07017-1620
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
361863
NY
Other
Enumeration date
10/18/2018
Last updated
10/18/2018
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