Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 431072 | NY |
NPI | 1033661160 |
---|---|
Provider Name | Rachael Grenfell-Dexter |
First Address | Brooklyn, NY 11215-2981 |
Second Address | Brooklyn, NY 11215-2981 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2016 |
Last Update Date | 24/10/2016 |