Provider Demographics
NPI:1841291853
Name:GRABOWY, MARION S (MD)
Entity type:Individual
Prefix:
First Name:MARION
Middle Name:S
Last Name:GRABOWY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3209
Mailing Address - Country:US
Mailing Address - Phone:203-407-3500
Mailing Address - Fax:203-281-1164
Practice Address - Street 1:84 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3061
Practice Address - Country:US
Practice Address - Phone:203-483-2024
Practice Address - Fax:203-483-2520
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT028752207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT050000703OtherMEDICARE
CT050000703OtherMEDICARE