Provider Demographics
NPI:1427002351
Name:BIALY, GRACE B (MD)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:B
Last Name:BIALY
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 1:88 PRINCETON HIGHTSTOWN RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PRINCETON JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-1100
Mailing Address - Country:US
Mailing Address - Phone:609-750-7330
Mailing Address - Fax:609-750-7336
Practice Address - Street 1:88 PRINCETON HIGHTSTOWN RD
Practice Address - Street 2:SUITE 203
Practice Address - City:PRINCETON JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08550-1100
Practice Address - Country:US
Practice Address - Phone:609-750-7330
Practice Address - Fax:609-750-7336
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA41147174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ000197698OtherHIGHMARK BLUE SHIELD
NJ1138901Medicaid
NJ1K7072OtherHEALTH NET
NJ3997131000OtherCIGNA
NJ0355213000OtherAMERIHEALTH
NJ3134040OtherAETNA
NJ390007800OtherR R MEDICARE
NJ3997131000OtherCIGNA
NJ390007800OtherR R MEDICARE