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NPI Code Detail

MEDICARE: DR. NATHAN MICHAEL GRABER MD

MEDICARE: DR. NATHAN MICHAEL GRABER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician228929NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780619213
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NATHAN MICHAEL GRABER MD
Provider Business Mailing Address
First Line : PO BOX 14890
Second Line :
City : ALBANY
State : NY
Zip : 12212-4890
Country : US
Telephone Number : 518-525-5634
Fax Number : 518-649-4094
Provider Business Practice Location Address
First Line : 4422 3RD AVE
Second Line : DEPARTMENT OF PEDIATRICS - SAINT BARNABAS HOSPITAL
City : BRONX
State : NY
Zip : 10457-2545
Country : US
Telephone Number : 718-960-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 05/21/2021

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