Provider Demographics
NPI:1992883557
Name:GRIGAUX, CLAIRE NATHALIE (MD)
Entity type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:NATHALIE
Last Name:GRIGAUX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 GALLOPING HILL ROAD
Practice Address - Street 2:DEVELOPMENTAL DISABILITIES CENTER
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083
Practice Address - Country:US
Practice Address - Phone:908-598-6655
Practice Address - Fax:908-686-8374
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83392207R00000X
NJ25MA08546700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A833920Medicaid
NJH47671Medicare PIN
NJH47671Medicare UPIN
H47671Medicare UPIN
00A833920Medicare ID - Type Unspecified