Individual
GRACE CHANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
1515 JOHN ST, FORT LEE, NJ 07024-2560
(201) 613-4844
Mailing address
1515 JOHN ST, FORT LEE, NJ 07024-2560
(201) 613-4844
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
872369
NJ
Other
Enumeration date
07/08/2009
Last updated
07/08/2009
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