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General NPI Number Information
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NPI Number | 1316996762
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Entity Type | Individual
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Provider Name | WILLIAM V LAGRADA MD
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Gender | Male
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 08/07/2015
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Provider Practice Location Address
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Address Line | 203 ROUTE 9
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City | ENGLISHTOWN
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State | NJ
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Zip | 07726-8270
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Country | US
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Telephone | 732-617-8800
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Fax | 732-617-8808
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Provider Business Mailing Address
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Address Line | 15 FORSYTHIA DR
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City | EDISON
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State | NJ
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Zip | 08837-3086
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Country | US
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Telephone | 732-549-3490
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Fax | 732-617-8808
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MA069932
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License Number State | NJ
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