Organization
GRADY ENDOCRINOLOGY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN GRADY MATRISCIANO M.D. (MANAGING MEMBER / OWNER)
(516) 380-1490
Entity
Organization
Contact information
Practice address
10512 S GLENSTONE PL, SUITE 102, BATON ROUGE, LA 70810-2966
(225) 505-5532
(225) 926-9674
Mailing address
10512 S GLENSTONE PL, SUITE 102, BATON ROUGE, LA 70810-2966
(225) 505-5532
(225) 926-9674
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD202783
LA
Other
Enumeration date
12/09/2014
Last updated
12/09/2014
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