Provider Demographics
NPI:1104855519
Name:GRABER, DAVID I (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:I
Last Name:GRABER
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 1:140 LITTLETON RD
Mailing Address - Street 2:STE 200
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-1867
Mailing Address - Country:US
Mailing Address - Phone:973-335-1100
Mailing Address - Fax:973-335-2660
Practice Address - Street 1:140 LITTLETON RD
Practice Address - Street 2:STE 200
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-1867
Practice Address - Country:US
Practice Address - Phone:973-335-1100
Practice Address - Fax:973-335-2660
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00313600111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
22-2883376OtherEIN
22-2883376OtherEIN