Individual
MS. ELIZABETH GRACE GLACE-HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1070 E 83RD ST, BROOKLYN, NY 11236-4226
(718) 241-5757
Mailing address
10579 SEAVIEW AVE, BROOKLYN, NY 11236-4625
(718) 629-2737
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
007535-1
NY
Other
Enumeration date
03/28/2012
Last updated
03/28/2012
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