Individual
PATRICK GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
746 JEFFERSON AVE, SCRANTON, PA 18510-1624
(570) 346-7797
(570) 342-9802
Mailing address
11781 LEE JACKSON MEMORIAL HWY, SUITE 550, FAIRFAX, VA 22033-3309
(571) 777-5102
(703) 563-6256
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD032741E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011278280001
—
PA
01
—
050015093
RR MEDICARE
PA
Enumeration date
12/19/2005
Last updated
05/19/2016
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