Individual
MS. BOBBY GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
474 DICK RD, APT A3, DEPEW, NY 14043-1404
(716) 573-1224
(716) 573-1224
Mailing address
474 DICK RD APT A3, DEPEW, NY 14043-1840
(716) 573-1224
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
327456
NY
Other
Enumeration date
02/06/2018
Last updated
02/06/2018
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