Healthcare Provider Details

I. General information

NPI: 1144588674
Provider Name (Legal Business Name): APRIL DANIELLE GRAHAM D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2012
Last Update Date: 05/28/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 PEARL ST
METUCHEN NJ
08840-1832
US

IV. Provider business mailing address

465 SOUTH STREET SUITE 103
MORRISTOWN MA
07050-2737
US

V. Phone/Fax

Practice location:
  • Phone: 732-590-6100
  • Fax: 732-590-6100
Mailing address:
  • Phone: 973-829-4080
  • Fax: 973-290-7495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MB09104200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: