Provider Demographics
NPI:1386629897
Name:GRAF, JEFFREY HOWARD (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:HOWARD
Last Name:GRAF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E 86TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-1057
Mailing Address - Country:US
Mailing Address - Phone:212-410-6001
Mailing Address - Fax:212-860-1946
Practice Address - Street 1:115 E 86TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-1057
Practice Address - Country:US
Practice Address - Phone:212-410-6001
Practice Address - Fax:212-860-1946
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-07
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY146672207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01043588Medicaid
NYNS481OtherOXFORD
NYNS481OtherOXFORD
NY68D981Medicare PIN