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1255952040
GRACIEUSE FONTAINE
BRENTWOOD, NY
NPI
1255952040
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 338203)
Enumeration Date
2020-05-03
Last Update Date
2020-05-03
Business Address
Ms. GRACIEUSE FONTAINE LPN
134 FLOYD ST
BRENTWOOD, NY 11717-2647
Phone number: 631-855-2787
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Mailing Address
Ms. GRACIEUSE FONTAINE LPN
134 FLOYD ST
BRENTWOOD, NY 11717-2647
Phone number: 631-855-2787
Copy
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