Provider Demographics
NPI:1356222350
Name:DOCTEUR, GRAYCE
Entity type:Individual
Prefix:
First Name:GRAYCE
Middle Name:
Last Name:DOCTEUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3260 BRANCHE RD
Mailing Address - Street 2:
Mailing Address - City:CAPE VINCENT
Mailing Address - State:NY
Mailing Address - Zip Code:13618-3178
Mailing Address - Country:US
Mailing Address - Phone:315-955-4109
Mailing Address - Fax:
Practice Address - Street 1:3260 BRANCHE RD
Practice Address - Street 2:
Practice Address - City:CAPE VINCENT
Practice Address - State:NY
Practice Address - Zip Code:13618-3178
Practice Address - Country:US
Practice Address - Phone:315-955-4109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program