Individual
GRACE MASABA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
2015 GRAND CONCOURSE, BRONX, NY 10453-4303
(718) 299-7295
(718) 299-6797
Mailing address
3198 GRAND CONCOURSE, BRONX, NY 10458-1000
(718) 618-0401
(347) 479-1303
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F307076
NY
Other
Enumeration date
09/29/2015
Last updated
07/21/2022
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