Individual
GRETCHEN DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2198 CRUGER AVE APT 3N, BRONX, NY 10462-1642
(832) 449-2488
Mailing address
2198 CRUGER AVE APT 3N, BRONX, NY 10462-1642
(832) 449-2488
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
623381
NY
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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