Individual
DR. GARY CHRIS DEGRANDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
33 N FULLERTON AVE, MONTCLAIR, NJ 07042-3464
(973) 744-2226
(973) 509-0978
Mailing address
33 N FULLERTON AVE, MONTCLAIR, NJ 07042-3464
(973) 744-2226
(973) 509-0978
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25MA03910400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47315986J
—
NJ
Enumeration date
11/28/2006
Last updated
04/16/2013
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