Provider Demographics
NPI:1386275444
Name:GRACE MEDICAL PC
Entity type:Organization
Organization Name:GRACE MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:INAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMASRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-915-2600
Mailing Address - Street 1:16 LEDGE HILL ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-3514
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:255 PARK AVE STE 800
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-1984
Practice Address - Country:US
Practice Address - Phone:857-810-0200
Practice Address - Fax:857-810-0200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty