Healthcare Provider Details

I. General information

NPI: 1588774046
Provider Name (Legal Business Name): WAYNE MICHAEL GRABOWSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 CENTER DR SUITE 1B
MONROE TOWNSHIP NJ
08831
US

IV. Provider business mailing address

5 CENTER DR SUITE 1B
MONROE TOWNSHIP NJ
08831
US

V. Phone/Fax

Practice location:
  • Phone: 609-409-2777
  • Fax: 609-409-2718
Mailing address:
  • Phone: 609-409-2777
  • Fax: 609-409-2718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number25MA03961900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: