Provider Demographics
NPI:1093816886
Name:GRABENSTATTER, DAVID EARL (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EARL
Last Name:GRABENSTATTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 MAIN ST
Mailing Address - Street 2:SUITE #2
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5430
Mailing Address - Country:US
Mailing Address - Phone:716-633-2233
Mailing Address - Fax:
Practice Address - Street 1:5555 MAIN ST
Practice Address - Street 2:SUITE #2
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5430
Practice Address - Country:US
Practice Address - Phone:716-633-2233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009237111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBB8155Medicare ID - Type Unspecified