Individual
BARBRARA GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
143 BAECH 26TH STREET, APT 2, FAR ROCKAWAY, NY 11691
(929) 326-5089
Mailing address
143 BEACH 26TH ST, FAR ROCKAWAY, NY 11691-2205
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
279681
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279681
—
NY
Enumeration date
11/22/2019
Last updated
11/22/2019
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