Provider Demographics
NPI:1790215176
Name:GRAEME WHYTE MD PC
Entity Type:Organization
Organization Name:GRAEME WHYTE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NASREEN
Authorized Official - Middle Name:RAZA
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-880-9792
Mailing Address - Street 1:PO BOX 5550
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-0391
Mailing Address - Country:US
Mailing Address - Phone:844-880-9792
Mailing Address - Fax:571-526-5530
Practice Address - Street 1:20 E 46TH ST FL 7
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-9282
Practice Address - Country:US
Practice Address - Phone:212-758-3939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1730512351OtherTYPE 1 NPI-INDIVIDUAL