Basic Information
| Provider Information | |||||||||
| NPI: | 1376773671 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | GRIECO | ||||||||
| FirstName: | RACHAEL | ||||||||
| MiddleName: | D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 ROBERT WOOD JOHNSON PL | ||||||||
| Address2: | MEB 342 | ||||||||
| City: | NEW BRUNSWICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 089011928 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322357893 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 ROBERT WOOD JOHNSON PL | ||||||||
| Address2: | MEB 342 | ||||||||
| City: | NEW BRUNSWICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 089011928 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322357893 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2009 | ||||||||
| LastUpdateDate: | 04/13/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 25MA08575100 | NJ | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.