Provider Demographics
NPI:1891402376
Name:GRAZIANO, NATALIE ROSE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ROSE
Last Name:GRAZIANO
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07014-1235
Mailing Address - Country:US
Mailing Address - Phone:973-901-0210
Mailing Address - Fax:
Practice Address - Street 1:382 W PASSAIC AVE STE 3
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-5555
Practice Address - Country:US
Practice Address - Phone:973-338-1900
Practice Address - Fax:201-918-3956
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01392800363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care