Individual
JANINE DENISE GRAYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
90 BERGEN ST, ER DEPARTMENT, NEWARK, NJ 07103-2425
(973) 972-5128
(973) 972-6646
Mailing address
30 BERGEN ST, ADMC 12 1205, NEWARK, NJ 07107-3000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA07936500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0100927
—
NJ
Enumeration date
09/22/2006
Last updated
02/22/2010
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