Provider Demographics
NPI:1003179755
Name:GRUMET, FRANCINE LYNN (BSMS)
Entity type:Individual
Prefix:MISS
First Name:FRANCINE
Middle Name:LYNN
Last Name:GRUMET
Suffix:
Gender:F
Credentials:BSMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 SOUTHGATE CIR
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-3808
Mailing Address - Country:US
Mailing Address - Phone:516-797-0602
Mailing Address - Fax:
Practice Address - Street 1:49 SOUTHGATE CIR
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA PARK
Practice Address - State:NY
Practice Address - Zip Code:11762-3808
Practice Address - Country:US
Practice Address - Phone:516-797-0602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106237012252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency