| Doctor Name: | ANGELA N DEGRAW |
| NPI Number: | 1457620767 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 580760-1 |
| Business Practice Address: | 239 Cayuga St Union Springs, NY - 131603107 |
| Business Phone Number: | 3158894128 |
| Business Fax Number: | 3158894133 |
| Mailing Address: | 239 Cayuga St, UNION SPRINGS |
| State: | NY |
| Postal Code: | 131603107 |
| Phone Number: | 3158894128 |
| Fax Number: | 3158894133 |
| NPI Enumeration Date: | 12/16/2011 |
| NPI Last Update Date: | 12/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WS0200X |
| License Number: | 580760-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |