Individual
GRACY P THEKKUMTHALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
301 SPRING GARDEN RD, HAMMONTON, NJ 08037-2516
(609) 561-1700
Mailing address
212 CHINKAPIN AVE, WILLIAMSTOWN, NJ 08094-8521
(908) 416-5675
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
26NJ15201100
NJ
Other
Enumeration date
12/28/2024
Last updated
12/28/2024
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