Provider Demographics
NPI:1891794178
Name:GORACCI, GRACE P (MD)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:P
Last Name:GORACCI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:P
Other - Last Name:GORACCI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:537 STANTON CHRISTIANA RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2146
Mailing Address - Country:US
Mailing Address - Phone:302-225-2380
Mailing Address - Fax:302-225-2388
Practice Address - Street 1:537 STANTON CHRISTIANA RD
Practice Address - Street 2:SUITE 203
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2146
Practice Address - Country:US
Practice Address - Phone:302-225-2380
Practice Address - Fax:302-225-2388
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10007471174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1891794178Medicaid
DE201375833OtherBCBS OF DE
DE201375833OtherBCBS OF DE