Individual
VICENTE H GRACIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
125 PATERSON ST, SUITE 4100, NEW BRUNSWICK, NJ 08901-1962
(732) 235-7920
(732) 235-7079
Mailing address
66 W GILBERT ST, 2ND FLOOR, TINTON FALLS, NJ 07701-4947
(732) 212-0051
(732) 212-0713
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
25MA08592500
NJ
2086S0102X
Surgical Critical Care Physician
25MA08592500
NJ
2086S0102X
Surgical Critical Care Physician
MD063973L
PA
2086S0127X
Trauma Surgery Physician
Primary
25MA08592500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017085020001
—
PA
05
—
7673302
—
NJ
01
—
P01069324
RAILROAD MEDICARE
NJ
Enumeration date
06/27/2006
Last updated
11/19/2012
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