Provider Information for 1518587179
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Mrs. DANIELLE R GRAY
Other Names:Former Name:Ms. DANIELLE R MARTINSex: Female
NPI: 1518587179
Last Updated: 2020-04-23
Certification Date: 2020-04-23
Certification Date: 2020-04-23
Details
| Name | Value | ||||||||
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| NPI | 1518587179 | ||||||||
| Enumeration Date | 2020-04-23 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 8126 MARGARET PL UNIT 2R GLENDALE, NY 11385-8045 United States Phone: 347-845-9481 | Fax: | ||||||||
| Primary Practice Address | 240 ROCKAWAY AVE STE 3 VALLEY STREAM, NY 11580-5841 United States Phone: 347-720-6199 | Fax: | ||||||||
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