Individual
GRACE ACOSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1420 LOCUST ST, PHILADELPHIA, PA 19102-4223
(215) 800-1909
Mailing address
220 S 47TH ST APT 238, PHILADELPHIA, PA 19139-4485
(267) 994-4257
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA063870
PA
Other
Enumeration date
09/01/2022
Last updated
09/01/2022
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