Individual
PAUL R. GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
403 BETHEL RD., SOMERS POINT, NJ 08244
(609) 927-8746
(609) 653-8807
Mailing address
403 BETHEL RD., SOMERS POINT, NJ 08244
(609) 927-8746
(609) 653-8807
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C5-0000142
DE
363AS0400X
Surgical Physician Assistant
C5-0000142
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02108
RX PA
—
Enumeration date
07/30/2009
Last updated
07/30/2009
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