Individual
CARLA Y. GROVATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
131 ROUTE 70 W, STE 100, MEDFORD, NJ 08055
(609) 267-9400
(609) 267-9457
Mailing address
4 EVES DR STE A100, MARLTON, NJ 08053-3126
(609) 267-9400
(609) 267-9457
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00000700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0342921
—
NJ
Enumeration date
07/03/2006
Last updated
07/09/2018
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