Provider Demographics
NPI:1821081373
Name:PAUL M.GRAPPELL,M.D.,JAMES T.WALKER,M.D.,P.C.
Entity Type:Organization
Organization Name:PAUL M.GRAPPELL,M.D.,JAMES T.WALKER,M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:M
Authorized Official - Last Name:GRAPPELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-822-3600
Mailing Address - Street 1:146 MANETTO HILL RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1324
Mailing Address - Country:US
Mailing Address - Phone:516-822-3600
Mailing Address - Fax:516-822-0008
Practice Address - Street 1:146 MANETTO HILL RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1324
Practice Address - Country:US
Practice Address - Phone:516-822-3600
Practice Address - Fax:516-822-0008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-30
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101823-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00175448Medicaid
NY01070488Medicaid
NYB15838Medicare UPIN
NY06J351Medicare PIN
NYB80597Medicare UPIN
NY01070488Medicaid
NY00175448Medicaid