Individual
GRANT CORONICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
429 RTE 79, STE 1, MORGANVILLE, NJ 07751
(732) 263-7970
(732) 263-7971
Mailing address
429 HWY 79, MORGANVILLE, NJ 07751-9800
(732) 263-7970
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA12141600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22-3471515
—
NJ
Enumeration date
03/25/2021
Last updated
11/07/2024
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