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1952625865
STACEY REBBIE GRANVILLE
JAMAICA, NY
NPI
1952625865
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 295683-1)
Enumeration Date
2010-03-22
Last Update Date
2010-03-22
Business Address
Miss STACEY REBBIE GRANVILLE LPN
14042 172ND ST
JAMAICA, NY 11434-4624
Phone number: 718-926-6744
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Mailing Address
Miss STACEY REBBIE GRANVILLE LPN
14042 172ND ST
JAMAICA, NY 11434-4624
Phone number: 718-926-6744
Copy
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