Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | MA85204 | NJ |
N | 207RP1001X | Pulmonary Disease | MA85204 | NJ |
N | 207RS0012X | Sleep Medicine | MA85204 | NJ |
NPI | 1033356027 |
---|---|
Provider Name | Thomas Grookett |
First Address | Marlton, NJ 08053-4197 |
Second Address | Marlton, NJ 08053-4145 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2009 |
Last Update Date | 20/10/2020 |