Provider Demographics
NPI:1639387368
Name:GRAZIANO, EUGENE M (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:M
Last Name:GRAZIANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:44 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07031-6350
Mailing Address - Country:US
Mailing Address - Phone:201-991-2880
Mailing Address - Fax:201-991-0027
Practice Address - Street 1:44 RIDGE RD
Practice Address - Street 2:
Practice Address - City:NORTH ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07031-6350
Practice Address - Country:US
Practice Address - Phone:201-991-2880
Practice Address - Fax:201-991-0027
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA01831700207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC61123Medicare UPIN