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Individual
DR. WILLIAM V LAGRADA
Active
Individual
DR. WILLIAM V LAGRADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MA069932
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0033855
—
NJ
01
—
1194996645
444 WILLIAM STREET
NJ
01
—
1740345693
741 BROADWAY
NJ
01
—
25MA06993200
NJ LICENSE
NJ
Enumeration date
05/10/2006
Last updated
08/07/2015
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