Grace Vero
Individual provider Active NPI Specialist · Palisades, NY
NPI 1629501952 · NPPES record last updated Apr 5, 2017
Key facts
- NPI
- 1629501952
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 960165151 (NY)
- Practice address
- 11 Horne Tooke Rd
Palisades, NY 10964-1403 - Phone
- (845) 521-8457
- NPI assigned
- Apr 4, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 1041532161 | NY | MD | Specialist |
| 960165151 | NY | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 960165151 | NY | Yes |
| Specialist | 174400000X | 1041532161 | NY |
Addresses
Primary practice location
11 Horne Tooke Rd
Palisades, NY 10964-1403
Mailing address
11 Horne Tooke Rd
Palisades, NY 10964-1403
Phone (845) 521-8457
Other providers in Palisades, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2017. 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.