Individual
CLEOPATRA GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
9832 57TH AVE APT 17N, CORONA, NY 11368-4941
(718) 592-0021
Mailing address
9832 57TH AVE APT 17N, CORONA, NY 11368-4941
(718) 592-0021
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
267510-1
NY
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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