Individual
ASHLEY GRACIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EMT
Contact information
Practice address
175 MUNN AVE UNIT 205, IRVINGTON, NJ 07111-2745
(646) 897-6131
Mailing address
175 MUNN AVE UNIT 205, IRVINGTON, NJ 07111-2745
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
631861
NJ
2255A2300X
Athletic Trainer
Primary
—
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
631861
EMT
NJ
Enumeration date
01/12/2021
Last updated
01/12/2021
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