GRACE MEDICAL CONSULT NPI 1104370915

NPI Information

NPI: 1104370915
Provider Name: GRACE MEDICAL CONSULT
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
40 UNION AVE
3RD FL. STE 301
IRVINGTON, NJ
ZIP 07111
Phone: (973) 996-2170
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GRACE MEDICAL CONSULT is a psychiatric/mental health nurse practitioner in Irvington, NJ. GRACE MEDICAL CONSULT NPI is 1104370915. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

40 UNION AVE
3RD FL. STE 301
IRVINGTON, NJ
ZIP 07111-277
Phone: (973) 996-2170

The provider's authorized official is Adewale Adefowoju .
The authorized official title is Medical Director and has the following contact phone number (908) 693-5036.

The enumeration date for this NPI number is 8/9/2016 and was last updated on 8/9/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	26NJ00196200	NEW JERSEY	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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