Joel E Grace, PH.D.
Individual provider Active NPI Intellectual & Developmental Disabilities Psychologist · Big Flats, NY
NPI 1982879516 · NPPES record last updated Apr 24, 2008
Key facts
- NPI
- 1982879516
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Intellectual & Developmental Disabilities Psychologist 103TM1800X
- License
- 7579 (NY)
- Practice address
- 3 Olcott Rd N
Big Flats, NY 14814-7901 - Phone
- (607) 562-7304
- Fax
- (607) 562-7304
- NPI assigned
- Apr 24, 2008
- 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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7579 | NY | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 7579 | NY | |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 7579 | NY | Yes |
Addresses
Primary practice location
3 Olcott Rd N
Big Flats, NY 14814-7901
Mailing address
3 Olcott Rd N
Big Flats, NY 14814-7901
Phone (607) 562-7304
Other providers in Big Flats, NY
- Amelia Joyce Dick
- Brett Dick
- Caren Douenias
- Elias Mounir Elias
- Foot and Ankle Specialists of the Twin Tiers, P. C.
- Derrik J Haradon-Chrisler
- Marta R Hernandez-Hermann
- Devin John Hull
- Joyce Ellen Hyatt
- Colleen Berry Ignaszewski
All providers in Big Flats, NY · Intellectual & Developmental Disabilities Psychologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2008. 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.