Individual
KATIE LEIGH GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
179 N BELLE MEAD RD, EAST SETAUKET, NY 11733-3528
(631) 444-2599
(631) 444-1474
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(631) 444-0650
(631) 638-4170
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
306512
NY
Other
Enumeration date
01/30/2014
Last updated
05/01/2014
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