MEDICARE: DR. GRACE CAROLINA IPARRAGUIRRE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	25MA12347400	NJ

General Provider Information

NPI Number	:	1467013649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GRACE CAROLINA IPARRAGUIRRE MD

Provider Business Mailing Address
First Line	:	3 VERMELLA WAY APT 3073
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-2633
Country	:	US
Telephone Number	:	973-356-7395
Fax Number	:

Provider Business Practice Location Address
First Line	:	12-35 RIVER RD
Second Line	:
City	:	FAIR LAWN
State	:	NJ
Zip	:	07410-1490
Country	:	US
Telephone Number	:	646-809-1750
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2019
Last Update Date	:	08/06/2024

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