Individual
GREGORY ROUSSEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
194 BROOKSIDE AVE UNIT 2, MOUNT VERNON, NY 10553-1304
(929) 351-9548
Mailing address
194 BROOKSIDE AVE UNIT 2, MOUNT VERNON, NY 10553-1304
(929) 351-9548
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
311471
NY
Other
Enumeration date
06/10/2025
Last updated
06/10/2025
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