Individual
MS. GRETTLE AGNES EVELYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 GUSTAVE L LEVY PL, NEW YORK, NY 10029-6500
(212) 241-6400
(212) 876-4671
Mailing address
2508 EDGEMERE AVE, FAR ROCKAWAY, NY 11691-2716
(718) 327-3205
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F302171
NY
Other
Enumeration date
08/03/2008
Last updated
08/03/2008
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