Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 105219 | NY |
NPI | 1003379967 |
---|---|
Provider Name | Zuleyka A Grullon |
First Address | New York, NY 10010-8154 |
Second Address | New York, NY 10010-8154 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2019 |
Last Update Date | 08/04/2019 |