Provider Demographics
NPI:1043278989
Name:MOY, GRACE K (MD)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:K
Last Name:MOY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:105 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-5314
Mailing Address - Country:US
Mailing Address - Phone:203-283-4334
Mailing Address - Fax:203-874-5209
Practice Address - Street 1:309 SEASIDE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-4625
Practice Address - Country:US
Practice Address - Phone:203-783-1831
Practice Address - Fax:203-874-5209
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT044274207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology