Robert Ulises Gracia, DVM
Individual provider Active NPI Veterinarian · Patterson, NY
NPI 1124996053 · NPPES record last updated Oct 23, 2025
Key facts
- NPI
- 1124996053
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Veterinarian 174M00000X
- License
- 013846 (NY)
- Practice address
- 40 Lakeport Dr
Patterson, NY 12563-1749 - Phone
- (203) 794-6313
- NPI assigned
- Oct 23, 2025
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013846 | NY | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Veterinarian |
174M00000X | 013846 | NY | Yes |
Addresses
Primary practice location
40 Lakeport Dr
Patterson, NY 12563-1749
Mailing address
40 Lakeport Dr
Patterson, NY 12563-1749
Phone (203) 794-6313
Other providers in Patterson, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.