Healthcare Provider Details

I. General information

NPI: 1003808296
Provider Name (Legal Business Name): JULIE GROVER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 06/29/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 HANDLEY ST
PERRY NY
14530-1342
US

IV. Provider business mailing address

3 HANDLEY ST
PERRY NY
14530-1342
US

V. Phone/Fax

Practice location:
  • Phone: 585-237-3227
  • Fax: 585-237-6075
Mailing address:
  • Phone: 585-237-3227
  • Fax: 585-237-6075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number332449
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF332449
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: