Individual
SHARDAE GRATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6542 N MASCHER ST, PHILADELPHIA, PA 19120-1040
(267) 212-2954
Mailing address
6542 N MASCHER ST, PHILADELPHIA, PA 19120-1040
(267) 212-2954
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
40963601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103732466-0001
—
PA
Enumeration date
05/26/2020
Last updated
05/26/2020
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