Individual
GRACY JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7925 WINCHESTER BLVD, QUEENS VILLAGE, NY 11427-2128
(718) 464-7500
Mailing address
7925 WINCHESTER BLVD, QUEENS VILLAGE, NY 11427-2128
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
424570
NY
Other
Enumeration date
02/03/2018
Last updated
03/17/2018
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