Individual
GRACE BERNAUDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 MINEOLA BLVD, MINEOLA, NY 11501-4089
(516) 663-3511
(516) 663-2308
Mailing address
151 INGRAHAM LN, NEW HYDE PARK, NY 11040-4275
(516) 437-0796
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
516568
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
309694
NY
Other
Enumeration date
04/24/2020
Last updated
09/09/2021
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