Provider Demographics
NPI:1225273733
Name:FUNG-ARTO, GRACE (PHD)
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:
Last Name:FUNG-ARTO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4537 194TH ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-3533
Mailing Address - Country:US
Mailing Address - Phone:718-428-6717
Mailing Address - Fax:718-352-0148
Practice Address - Street 1:4537 194TH ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-3533
Practice Address - Country:US
Practice Address - Phone:718-428-6717
Practice Address - Fax:718-352-0148
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014617103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist