214-18 Hillside Ave

NPI 1063858991 - Counselor - 101Y00000X

NPI Details
NPI 1063858991
Enumeration Date 05/19/2013
Last Updated 05/19/2013
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name GRACEMON GRACEMON
Position CEO
Phone (646) 331-7345
Fax
Practice Location
21418 HILLSIDE AVE
QUEENS VILLAGE NY, 11427-1808, US
Phone (646) 331-7345
Fax
Business Location
21418 HILLSIDE AVE
QUEENS VILLAGE NY, 11427-1808, US
Phone (646) 331-7345
Fax
Toxanomy
Taxonomy Code 101Y00000X
License State
License Number
Remove 1063858991 NPI Number
 

According to our database, 214-18 Hillside Ave NPI is 1063858991, taxonomy code is 101Y00000X 214-18 Hillside Ave physically located at 21418 Hillside Ave, Queens Village NY, 11427-1808. NPI Number 1033115704 has the healthcare provider type.

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1063858991 NPI number is provided on an as is basis without warranty of any kind. 1063858991 is maintained by the National Plan & Provider Enumeration System. The contents of 214-18 Hillside Ave are for informational purposes only.