Individual
GRACE AMISTOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
LOCK BAG & WOODBRIGE AVE, E JERSEY STATE PRISON ATTN MEDICAL DEPT, WOODBRIDGE, NJ 07067
(732) 499-5010
Mailing address
LOCKBAG R, E JERSEY STATE PRISON ATTN MEDICAL DEPT, RAHWAY, NJ 07106
(732) 399-5010
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NC06249800
NJ
Other
Enumeration date
09/25/2013
Last updated
09/25/2013
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