Individual
JEFFREY SCOTT GROGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
70 MALTA AVE, BALLSTON SPA, NY 12020-1599
(518) 884-7195
Mailing address
604 CINDY LN, BALLSTON SPA, NY 12020-3516
(518) 257-2369
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
507680
NY
Other
Enumeration date
05/31/2023
Last updated
05/31/2023
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