Provider Demographics
NPI:1093956682
Name:WILLIAM A GRABER MD PC
Entity Type:Organization
Organization Name:WILLIAM A GRABER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRABER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-624-4740
Mailing Address - Street 1:1724 BURRSTONE RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-1002
Mailing Address - Country:US
Mailing Address - Phone:315-624-4740
Mailing Address - Fax:315-624-4760
Practice Address - Street 1:125 BUSINESS PARK DR STE 150
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-6316
Practice Address - Country:US
Practice Address - Phone:315-235-2540
Practice Address - Fax:315-235-2171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Multi-Specialty