Provider Demographics
NPI:1164590402
Name:GRAPEL, FRED ELLIOT (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:ELLIOT
Last Name:GRAPEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 W 48TH ST
Mailing Address - Street 2:SUITE 703
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10036
Mailing Address - Country:US
Mailing Address - Phone:212-768-0540
Mailing Address - Fax:212-768-1040
Practice Address - Street 1:48 W 48TH ST
Practice Address - Street 2:SUITE 703
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10036
Practice Address - Country:US
Practice Address - Phone:212-768-0540
Practice Address - Fax:212-768-1040
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY364031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice