Individual
MARK SCOTT GRAVENSTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1128 BAY AVE APT 14, OCEAN CITY, NJ 08226-3300
(609) 220-3726
Mailing address
1128 BAY AVE APT 14, OCEAN CITY, NJ 08226-3300
(609) 220-3726
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI01770000
NJ
Other
Enumeration date
01/21/2021
Last updated
01/21/2021
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