Provider Demographics
NPI:1740714047
Name:GRABER, MELANIE RACHEL
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:RACHEL
Last Name:GRABER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GRAND ST STE E119
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-2016
Mailing Address - Country:US
Mailing Address - Phone:860-224-5990
Mailing Address - Fax:
Practice Address - Street 1:100 GRAND STREET
Practice Address - Street 2:OUTPATIENT CLINIC - THE HOSPITAL OF CENTRAL CONNECTICUT
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06050
Practice Address - Country:US
Practice Address - Phone:860-224-5261
Practice Address - Fax:860-224-5957
Is Sole Proprietor?:No
Enumeration Date:2017-04-13
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT066544207R00000X
390200000X
NY319002207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program