Provider Demographics
NPI:1114470218
Name:BELLANTUONO, GRACE (NP-FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:GRACE
Middle Name:
Last Name:BELLANTUONO
Suffix:
Gender:F
Credentials:NP-FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 MASON AVENUE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305
Mailing Address - Country:US
Mailing Address - Phone:718-351-3933
Mailing Address - Fax:718-351-2873
Practice Address - Street 1:271 MASON AVENUE
Practice Address - Street 2:WISSAM HOYEK MD.
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305
Practice Address - Country:US
Practice Address - Phone:718-351-3933
Practice Address - Fax:718-351-2873
Is Sole Proprietor?:No
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338913363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily