Provider Demographics
NPI:1124996053
Name:GRACIA, ROBERT ULISES (DVM)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ULISES
Last Name:GRACIA
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 LAKEPORT DR
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:NY
Mailing Address - Zip Code:12563-1749
Mailing Address - Country:US
Mailing Address - Phone:203-794-6313
Mailing Address - Fax:
Practice Address - Street 1:40 LAKEPORT DR
Practice Address - Street 2:
Practice Address - City:PATTERSON
Practice Address - State:NY
Practice Address - Zip Code:12563-1749
Practice Address - Country:US
Practice Address - Phone:203-794-6313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013846174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174M00000XOther Service ProvidersVeterinarianGroup - Single Specialty