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NPI Code Detail

MEDICARE: DR. GRACIA ETIENNE MD

MEDICARE: DR. GRACIA ETIENNE 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
1207XS0114XAdult Reconstructive Orthopaedic Surgery PhysicianMD425799PA

General Provider Information

NPI Number : 1669479788
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GRACIA ETIENNE MD
Provider Business Mailing Address
First Line : 1861 POWDER MILL RD
Second Line : ATTN MSO
City : YORK
State : PA
Zip : 17402-4723
Country : US
Telephone Number : 717-718-2041
Fax Number : 717-741-9867
Provider Business Practice Location Address
First Line : 1855 POWDER MILL RD
Second Line :
City : YORK
State : PA
Zip : 17402-4723
Country : US
Telephone Number : 717-848-4800
Fax Number : 717-741-9867
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2005
Last Update Date : 05/08/2024

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Directions to “ DR. GRACIA ETIENNE MD” Practice Location

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