| Doctor Name: | ANN D GRACER |
| NPI Number: | 1063407054 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | 01778 |
| Business Practice Address: | 6724 165th St Fresh Meadows, NY - 113653204 |
| Business Phone Number: | 7184634640 |
| Business Fax Number: | 7184634655 |
| Mailing Address: | 6724 165th St, FRESH MEADOWS |
| State: | NY |
| Postal Code: | 113653204 |
| Phone Number: | 7184634640 |
| Fax Number: | 7184634655 |
| NPI Enumeration Date: | 09/15/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TA0700X |
| License Number: | 01778 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Adult Development & Aging |
| Taxonomy Definition: | |