Porsia Graham

Key facts

NPI

1295313989

Entity type

Individual (NPI type 1)

Primary specialty

Health Service Clinic/Center 261QH0100X

Practice address

100 Hamilton Ave
Fords, NJ 08863-1916

Phone

(732) 890-9015

NPI assigned

Apr 1, 2021

Sex

Female

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

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 1, 2021.

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1295313989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 NEW ST APT 428",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088401978",
            "telephone_number": "732-895-9015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HAMILTON AVE",
            "city": "FORDS",
            "state": "NJ",
            "postal_code": "088631916",
            "telephone_number": "732-890-9015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "PORSIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-01",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Fords, NJ · Health Service Clinic/Center in New Jersey