| Doctor Name: | MS. GERALDINE DESGRAVIERS |
| NPI Number: | 1265715924 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | 624105 |
| Business Practice Address: | 89 S 25th St Wyandanch, NY - 117982905 |
| Business Phone Number: | 6315757260 |
| Business Fax Number: | |
| Mailing Address: | 88 W Farm Dr, MELVILLE |
| State: | NY |
| Postal Code: | 117474153 |
| Phone Number: | 6315757260 |
| Fax Number: | |
| NPI Enumeration Date: | 09/20/2011 |
| NPI Last Update Date: | 09/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0000X |
| License Number: | 624105 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | General Practice |
| Taxonomy Definition: | |