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NPI Code Detail

MEDICARE: GRACE E MILLS PSS

MEDICARE: GRACE E MILLS PSS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1811847411
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE E MILLS PSS
Provider Business Mailing Address
First Line : 324 COUNTY ROUTE 51 BLDG 1
Second Line :
City : MALONE
State : NY
Zip : 12953-4502
Country : US
Telephone Number : 518-483-1251
Fax Number : 518-483-2242
Provider Business Practice Location Address
First Line : 1003 PARK ST
Second Line :
City : OGDENSBURG
State : NY
Zip : 13669-3911
Country : US
Telephone Number : 315-713-9090
Fax Number : 315-713-9330
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2026
Last Update Date : 02/02/2026

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Directions to “ GRACE E MILLS PSS” Practice Location

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