Provider Demographics
NPI:1710209606
Name:GRAFF, AILENE (BS RPH)
Entity Type:Individual
Prefix:MS
First Name:AILENE
Middle Name:
Last Name:GRAFF
Suffix:
Gender:F
Credentials:BS RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 N RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-2111
Mailing Address - Country:US
Mailing Address - Phone:845-354-0842
Mailing Address - Fax:866-696-8211
Practice Address - Street 1:2 N RIDGE RD
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-2111
Practice Address - Country:US
Practice Address - Phone:845-354-0842
Practice Address - Fax:866-696-8211
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY316711835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric