Individual
MISS GRACE PAIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.P.
Contact information
Practice address
1233 LOCUST STREET 4TH FLOOR, PHILADELPHIA, PA 19107-5453
(215) 790-1788
(215) 732-5490
Mailing address
1233 LOCUST ST THIRD FLOOR, PHILADELPHIA, PA 19107-5400
(215) 985-4448
(215) 732-1145
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP010854
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102970866
—
PA
Enumeration date
02/02/2011
Last updated
03/17/2018
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