Basic Information
| Provider Information | |||||||||
| NPI: | 1093846032 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRAZIANO | ||||||||
| FirstName: | PAULA | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1907 STATE ROUTE 35 | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | OAKHURST | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077552765 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7325170060 | ||||||||
| FaxNumber: | 7323801965 | ||||||||
| Practice Location | |||||||||
| Address1: | 1907 STATE ROUTE 35 | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | OAKHURST | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077552765 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7325170060 | ||||||||
| FaxNumber: | 7323801965 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 26NJ00120300 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.