Individual
MRS. CATHERINE TRACY GRIMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
4319 247TH ST, LITTLE NECK, NY 11363-1644
(646) 269-9111
Mailing address
4319 247TH ST, LITTLE NECK, NY 11363-1644
(646) 269-9111
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1809626
NY
Other
Enumeration date
11/23/2011
Last updated
11/23/2011
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