Organization
GIZELLE MANOAH, PC, INC
Active
Organization
GIZELLE MANOAH, PC, INC
Active
Parent organization
GIZELLEMANOAH, PC, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GIZELLEMANOAH, PC, INC
Authorized official
ANNE-MARIE GIZELLE GRACIA MD (PRESIDENT)
(973) 243-0220
Entity
Organization
Contact information
Practice address
59 MAIN ST, SUITE 204, WEST ORANGE, NJ 07052-5341
(973) 243-0220
Mailing address
PO BOX 3122, MEMORIAL STATION, UPPER MONTCLAIR, NJ 07043-3122
(973) 243-0220
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
MA58440
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6560610
—
NJ
Enumeration date
04/05/2012
Last updated
04/05/2012
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