Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 25MA03861600 | NJ |
NPI | 1427174028 |
---|---|
Provider Name | Robert A Graebe |
First Address | Newark, NJ 07192-5378 |
Second Address | Long Branch, NJ 07740-6303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0421804 | (05) | NJ |
C54588 | (02) | NJ |