Provider Demographics
NPI:1851432801
Name:GRAMBAU, ROBERT FRASER (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FRASER
Last Name:GRAMBAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:461 SMITH RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10590-2626
Mailing Address - Country:US
Mailing Address - Phone:914-364-6694
Mailing Address - Fax:
Practice Address - Street 1:461 SMITH RIDGE RD
Practice Address - Street 2:
Practice Address - City:SOUTH SALEM
Practice Address - State:NY
Practice Address - Zip Code:10590-2626
Practice Address - Country:US
Practice Address - Phone:914-364-6694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1585002084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry