Healthcare Provider Details

I. General information

NPI: 1952302192
Provider Name (Legal Business Name): DONATELLA B GRAFFINO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 12/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 SADDLE RD FIRST FLOOR
CEDAR KNOLLS NJ
07927-1902
US

IV. Provider business mailing address

8 SADDLE RD FIRST FLOOR
CEDAR KNOLLS NJ
07927-1902
US

V. Phone/Fax

Practice location:
  • Phone: 973-267-9393
  • Fax: 973-540-0472
Mailing address:
  • Phone: 973-267-9393
  • Fax: 973-540-0472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number25MA04299400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: