Grady, Thomas Joseph
Grady, Thomas Joseph is an sole proprietor health care provider with primary practice located at 20 Hope Ave Ste. 207, Waltham MA 02453-2721. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Grady, Thomas Joseph can be contacted via phone (781) 893-6520.Contact Information
Primary practice address
20 Hope Ave Ste. 207
Waltham MA 02453-2721
Phone: (781) 893-6520
Fax: (781) 893-6522
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Surgery | 208600000X | A34515 | Massachusetts |
Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 34153 | Massachusetts |
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery | 208C00000X | 34153 | Massachusetts |
Profile Details
NPI number | 1518949346 |
---|---|
LBN Legal business name | Grady, Thomas Joseph |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Nov 17th, 2005 |
Last updated | May 20th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1518949346 | NPPES |
Massachusetts | MEDICAID | 2019701 | |
Massachusetts | Other | AX0126 | |
Massachusetts | Other | 020909149 |
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