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Individual

MRS. GRACE SHAJI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
333 COTTMAN AVE, PHILADELPHIA, PA 19111-2434
(215) 728-6900
(215) 214-1425
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 728-2844
(215) 214-1425

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
SP012007
PA

Other

Enumeration date
06/28/2012
Last updated
03/23/2017
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