Provider Demographics
NPI:1417839689
Name:GRAU, SADIE MAE
Entity type:Individual
Prefix:MS
First Name:SADIE
Middle Name:MAE
Last Name:GRAU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 LAYTON RD
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:NJ
Mailing Address - Zip Code:07461-3311
Mailing Address - Country:US
Mailing Address - Phone:973-534-1589
Mailing Address - Fax:
Practice Address - Street 1:89 LAYTON RD
Practice Address - Street 2:
Practice Address - City:SUSSEX
Practice Address - State:NJ
Practice Address - Zip Code:07461-3311
Practice Address - Country:US
Practice Address - Phone:973-534-1589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant