Individual
GRACE OH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
579 LINDEN AVE, TEANECK, NJ 07666-2339
(201) 835-4660
Mailing address
1608 LEMOINE AVE, FORT LEE, NJ 07024-5622
(201) 585-9921
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NR22072300
NJ
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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