Provider Demographics
NPI:1720537400
Name:GRAZIER, ERIK
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:
Last Name:GRAZIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 POST ST
Mailing Address - Street 2:APT 2
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-6048
Mailing Address - Country:US
Mailing Address - Phone:845-750-4350
Mailing Address - Fax:
Practice Address - Street 1:42 POST ST
Practice Address - Street 2:APT 2
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-6048
Practice Address - Country:US
Practice Address - Phone:845-750-4350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9428531163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse