Healthcare Provider Details

I. General information

NPI: 1487148094
Provider Name (Legal Business Name): GRACE GARLINGTON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2018
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 W 36TH ST
NEW YORK NY
10018-7902
US

IV. Provider business mailing address

65 W 36TH ST
NEW YORK NY
10018-7902
US

V. Phone/Fax

Practice location:
  • Phone: 888-803-3370
  • Fax:
Mailing address:
  • Phone: 888-803-3370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number1010134143
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1010134143
License Number StateVT
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number343099
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: