Provider Demographics
NPI:1003590076
Name:GRAZIANO, VINCENT (IHP2, PHD)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:
Last Name:GRAZIANO
Suffix:
Gender:M
Credentials:IHP2, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 NORWOOD AVE APT A10
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-1915
Mailing Address - Country:US
Mailing Address - Phone:808-202-6484
Mailing Address - Fax:
Practice Address - Street 1:15 NORWOOD AVE APT A10
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-1915
Practice Address - Country:US
Practice Address - Phone:808-202-6484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach