| Doctor Name: | MARIE GRACE SWENSON |
| NPI Number: | 1790111292 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 71004635A |
| Business Practice Address: | 835 Roosevelt Ave Carteret, NJ - 070081815 |
| Business Phone Number: | 7329692240 |
| Business Fax Number: | 7329692152 |
| Mailing Address: | 33 Cedar Ave, HIGHLAND PARK |
| State: | NJ |
| Postal Code: | 089042101 |
| Phone Number: | 3146917902 |
| Fax Number: | |
| NPI Enumeration Date: | 09/17/2013 |
| NPI Last Update Date: | 11/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 71004635A |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |