Individual
MRS. GRACE SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
615 HOPE RD, EATONTOWN, NJ 07724-1277
(732) 571-1000
(732) 571-1156
Mailing address
44 CONCANNON DR, FORDS, NJ 08863-1322
(732) 710-3314
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00411300
NJ
Other
Enumeration date
12/20/2012
Last updated
06/20/2013
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