Individual
PATRICIA GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
220 MOUNT VERNON PL, NEWARK, NJ 07106-3146
(718) 671-2100
Mailing address
220 MOUNT VERNON PL, NEWARK, NJ 07106-3146
(718) 671-2100
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
300938
NY
Other
Enumeration date
06/16/2010
Last updated
06/16/2010
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