Healthcare Provider Details

I. General information

NPI: 1891794178
Provider Name (Legal Business Name): GRACE P GORACCI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GRACE P GORACCI MD

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 12/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

537 STANTON CHRISTIANA RD SUITE 203
NEWARK DE
19713-2146
US

IV. Provider business mailing address

537 STANTON CHRISTIANA RD SUITE 203
NEWARK DE
19713-2146
US

V. Phone/Fax

Practice location:
  • Phone: 302-225-2380
  • Fax: 302-225-2388
Mailing address:
  • Phone: 302-225-2380
  • Fax: 302-225-2388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberC10007471
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: