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General NPI Number Information
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NPI Number | 1659574507
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Entity Type | Organization
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Legal Business Name | JANE PRATT-GRIPPI D.P.M.,P.C.
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 10/27/2008
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Provider Practice Location Address
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Address Line | 4729 193RD ST
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City | FLUSHING
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State | NY
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Zip | 11358-3928
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Country | US
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Telephone | 718-225-7344
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Fax | 718-225-7346
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Provider Business Mailing Address
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Address Line | 4729 193RD ST
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City | FLUSHING
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State | NY
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Zip | 11358-3928
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Country | US
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Telephone | 718-225-7344
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Fax | 718-225-7346
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JANE IRENE PRATT-GRIPPI
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Credential | D.P.M.
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Telephone | 718-225-7344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | N004315
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License Number State | NY
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