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1730727165
GERARD FITZGERALD GRANT
BRENTWOOD, NY
NPI
1730727165
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 336676-01)
Enumeration Date
2019-12-17
Last Update Date
2019-12-17
Business Address
GERARD FITZGERALD GRANT
998 CROOKED HILL RD
BRENTWOOD, NY 11717-1019
Phone number: 631-761-3500
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Mailing Address
GERARD FITZGERALD GRANT
14045 169TH ST
JAMAICA, NY 11434-5958
Phone number: 718-306-7917
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