Basic Information
Provider Information | |||||||||
NPI: | 1356322770 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | GRAFMULLER | ||||||||
FirstName: | DAVID | ||||||||
MiddleName: | ANDREW | ||||||||
NamePrefix: | MR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.S.P.T., CLT | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 167 MYERS CORNERS RD | ||||||||
Address2: | SUITE 200 | ||||||||
City: | WAPPINGERS FALLS | ||||||||
State: | NY | ||||||||
PostalCode: | 125903869 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8452985000 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 167 MYERS CORNERS RD | ||||||||
Address2: | SUITE 200 | ||||||||
City: | WAPPINGERS FALLS | ||||||||
State: | NY | ||||||||
PostalCode: | 125903869 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8452985000 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 11/11/2005 | ||||||||
LastUpdateDate: | 11/08/2010 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 024367 | NY | Y |   | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |   |
ID Information
ID | Type | State | Issuer | Description | 2312986 | 01 |   | UNITED HEALTH CARE | OTHER | 3093052 | 01 |   | AETNA HMO | OTHER | 833753 | 01 |   | MANAGED PHYSICAL NETWORK | OTHER | 10086291 | 01 |   | CDPHP | OTHER | 98446 | 01 |   | OPERATING ENGNRS LCL 825 | OTHER | Q09S31 | 01 |   | BLUE CROSS BLUE SHIELD | OTHER | 000409359001 | 01 |   | HEALTH NOW | OTHER | 2164971 | 01 |   | CCN | OTHER | P3297940 | 01 |   | OXFORD | OTHER | 4126156 | 01 |   | MVP | OTHER | 7300422 | 01 |   | AETNA PPO | OTHER |