Individual
MRS. IVOLYN DOREEN GREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1 PENN PLZ, SUITE 725, NEW YORK, NY 10119-0002
(347) 515-2656
Mailing address
25524 148TH RD, ROSEDALE, NY 11422-2808
(718) 712-6043
(718) 712-6043
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F305915-1
NY
Other
Enumeration date
08/09/2012
Last updated
06/04/2014
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