Individual
MRS. BIANCA TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
317 GIFFORDS LN, STATEN ISLAND, NY 10308-1601
(917) 829-1096
Mailing address
317 GIFFORDS LN, STATEN ISLAND, NY 10308-1601
(917) 829-1096
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
025534
NY
Other
Enumeration date
10/30/2017
Last updated
10/30/2017
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