Individual ProviderAlie Theresa Massicot-GrayNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address451 Clarkson Ave, Brooklyn, NY 11203-2054(718) 245-2000PECOS EnrollmentBased on the most recent information from CMS, provider Alie Theresa Massicot-Gray does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1407120918Provider TypeIndividualFull NameMassicot-Gray, Alie TheresaTitleMs.CredentialFNPGenderFemaleSole ProprietorYesEnumeration Date3/1/2012Last Updated4/5/2012Contact InformationPractice LocationPractice Address451 Clarkson Ave, Brooklyn, NY 11203-2054Phone(718) 245-2000FaxUnlisted FaxMailing LocationMailing Address451 Clarkson Ave, Brooklyn, NY 11203-2054PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseF336532-1New York