Provider Demographics
NPI:1871501858
Name:GRAICHEN, ALAN R (PA C)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:R
Last Name:GRAICHEN
Suffix:
Gender:M
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:280 CHESTNUT STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:424 STATE ROAD
Practice Address - Street 2:
Practice Address - City:WHATELY
Practice Address - State:MA
Practice Address - Zip Code:01093
Practice Address - Country:US
Practice Address - Phone:413-665-8517
Practice Address - Fax:413-665-8741
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA158363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical