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GRANT PRUD'HOMME

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RNFA

Contact information

Practice address
214 KING ST STE A, OGDENSBURG, NY 13669-1142
(315) 393-3600
Mailing address
214 KING ST STE A, OGDENSBURG, NY 13669-1142
(315) 393-3600

Taxonomy

Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
470560
NY

Other

Enumeration date
01/21/2026
Last updated
01/21/2026
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