Provider Demographics
NPI:1962165449
Name:GRAFF, HOLLY REBEKAH (LM, CPM)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:REBEKAH
Last Name:GRAFF
Suffix:
Gender:
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-4430
Mailing Address - Country:US
Mailing Address - Phone:917-992-4623
Mailing Address - Fax:
Practice Address - Street 1:159 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-4430
Practice Address - Country:US
Practice Address - Phone:917-992-4623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-20
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-316788174N00000X
NJ25MW00003700176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No176B00000XOther Service ProvidersMidwife