31D0974095 CLIA NUMBER - ANNE MARIE GRACIA MD

Laboratory Demographics

CLIA Number: 31D0974095

Facility Name: ANNE MARIE GRACIA MD

Facility Address:
59 MAIN STREET SUITE 204
WEST ORANGE, NJ
ZIP 07052
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Facility Phone Number: 973 243-0220

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1447328018

Taxonomy: 207RG0300X - Internal Medicine
An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.

CLIA Record

Field Name	Field Value
CLIA Number	31D0974095
LAB Type	Physician Office
Facility Name	ANNE MARIE GRACIA MD
Street	59 MAIN STREET SUITE 204
City	WEST ORANGE
State	NJ
ZIP	07052
Phone	973 243-0220
CertificateType	4
CertificateEffectiveDate	5/26/2022
CertificateExpirationDate	5/25/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024