=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982680575
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN W GRAEF M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/16/2005
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 333 LONGWOOD AVE
-----------------------------------------------------
City | BOSTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02115-5711
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-355-8263
-----------------------------------------------------
Fax | 617-277-8934
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 147 MILK STREET PROVIDER ENROLLMENT - 9TH FLOOR
-----------------------------------------------------
City | BOSTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02109-4862
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-559-8053
-----------------------------------------------------
Fax | 617-421-3487
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 33948
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2080T0002X
-----------------------------------------------------
Taxonomy Name | Pediatric Medical Toxicology Physician
-----------------------------------------------------
License Number | 33948
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 208M00000X
-----------------------------------------------------
Taxonomy Name | Hospitalist Physician
-----------------------------------------------------
License Number | 33948
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------