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General NPI Number Information
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NPI Number | 1689674129
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Entity Type | Individual
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Provider Name | DOUGLAS K GRAYSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/27/2005
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Last Update Date | 04/24/2017
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Provider Practice Location Address
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Address Line | 485A US HIGHWAY 1 S BUILDING A
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City | ISELIN
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State | NJ
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Zip | 08830-3012
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Country | US
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Telephone | 732-750-0400
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Fax | 732-750-1507
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Provider Business Mailing Address
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Address Line | 485A US HIGHWAY 1 S BUILDING A
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City | ISELIN
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State | NJ
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Zip | 08830-3012
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Country | US
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Telephone | 732-750-0400
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Fax | 732-750-1507
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 25MA06225100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 1827361
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207WX0009X
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Taxonomy Name | Glaucoma Specialist (Ophthalmology) Physician
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License Number | 25MA06225100
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 207WX0009X
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Taxonomy Name | Glaucoma Specialist (Ophthalmology) Physician
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License Number | 182736-1
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License Number State | NY
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