Individual
MELISSA J. GRAULE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
72 W JIMMIE LEEDS RD, SUITE 1100, GALLOWAY, NJ 08205-9406
(609) 677-9729
Mailing address
95 HIGHLAND AVE, STE 130, BETHLEHEM, PA 18017-9483
(610) 868-1100
(610) 868-1111
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25MA08013300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0097381
—
NJ
01
—
P00401588
RAILROAD MEDICARE
NJ
01
—
P00793706
RAILROAD MEDICARE
NJ
01
—
P00847779
RAILROAD MEDICARE
NJ
Enumeration date
05/11/2006
Last updated
10/30/2019
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