Doctor Name: | ALAN R GRAICHEN |
NPI Number: | 1871501858 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA C |
License Number: | 158 |
Business Practice Address: | 424 State Road Whately, MA - 01093 |
Business Phone Number: | 4136658517 |
Business Fax Number: | 4136658741 |
Mailing Address: | 280 Chestnut Street, 2nd Floor SPRINGFIELD |
State: | MA |
Postal Code: | 01199 |
Phone Number: | 4137945700 |
Fax Number: | |
NPI Enumeration Date: | 08/04/2006 |
NPI Last Update Date: | 05/13/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 158 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |