Individual
PATRICE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
85 W BURNSIDE AVE, BRONX, NY 10453
(718) 716-4400
Mailing address
85 W BURNSIDE AVE, BRONX, NY 10453-4015
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV008455
NY
Other
Enumeration date
05/16/2016
Last updated
10/07/2019
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