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:
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Health care specialties

SpecialtyCodeLicense #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 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518949346 NPPES
Massachusetts MEDICAID 2019701
Massachusetts Other AX0126
Massachusetts Other 020909149

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