GRANT DALE-DERKS

BRONX, NY
NPI1386303550
Other NameGRANT DALE DERKS
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2021-12-14
Last Update Date2026-02-18
Business Address
GRANT DALE-DERKS DO
4422 3RD AVE
BRONX, NY 10457-2545
Phone number: 718-960-9000
Mailing Address
GRANT DALE-DERKS DO
333 HUGUENOT ST APT P112
NEW ROCHELLE, NY 10801-7350
Phone number: 636-541-8934
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