Individual
DOROTHY THERESA GRANDINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 ROANOKE AVE # ICU, RIVERHEAD, NY 11901-2031
(516) 658-2494
Mailing address
1300 ROANOKE AVE, FLANDERS, NY 11901-2031
(631) 548-6000
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
311646
NY
Other
Enumeration date
12/27/2023
Last updated
12/27/2023
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