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General NPI Number Information
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NPI Number | 1760272405
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Entity Type | Individual
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Provider Name | DEANDRIENNE VICTORIA GREGG
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Gender | Female
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 424 E 147TH ST FL 1
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City | BRONX
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State | NY
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Zip | 10455-4104
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Country | US
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Telephone | 212-553-6708
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Fax |
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Provider Business Mailing Address
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Address Line | 219 KINGSBOROUGH 2ND WALK APT 3B
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City | BROOKLYN
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State | NY
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Zip | 11233-3628
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Country | US
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Telephone | 718-200-2030
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 972711
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License Number State | NY
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