Provider Demographics
NPI:1225573967
Name:MORABIA, GRACE (RN)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:MORABIA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1731
Mailing Address - Country:US
Mailing Address - Phone:732-832-9200
Mailing Address - Fax:
Practice Address - Street 1:405 LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-1731
Practice Address - Country:US
Practice Address - Phone:732-832-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY722101163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse