Provider Demographics
NPI:1366477283
Name:O'GRADY, JOHN P (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:O'GRADY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:220 RIDGEDALE AVE
Mailing Address - Street 2:SUITE C2
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1361
Mailing Address - Country:US
Mailing Address - Phone:973-538-5844
Mailing Address - Fax:973-267-0181
Practice Address - Street 1:220 RIDGEDALE AVE
Practice Address - Street 2:SUITE C2
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1361
Practice Address - Country:US
Practice Address - Phone:973-538-5844
Practice Address - Fax:973-267-0181
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2013-02-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA56380207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5541204Medicaid
NJF64985Medicare UPIN
NJ127133MNGMedicare ID - Type Unspecified