Provider Demographics
NPI:1578139010
Name:GRASKEMPER, ERIN (LMT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:GRASKEMPER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 COUNTY RD APT 206
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-1865
Mailing Address - Country:US
Mailing Address - Phone:937-269-6624
Mailing Address - Fax:
Practice Address - Street 1:140 COUNTY RD APT 206
Practice Address - Street 2:
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670-1865
Practice Address - Country:US
Practice Address - Phone:937-269-6624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00637700225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist