Provider Demographics
NPI:1144588674
Name:GRAHAM, APRIL DANIELLE (DO)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:DANIELLE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 SOUTH STREET
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MORRISTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:07050-2737
Mailing Address - Country:US
Mailing Address - Phone:973-829-4080
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:45 PEARL ST
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-1832
Practice Address - Country:US
Practice Address - Phone:732-590-6100
Practice Address - Fax:732-590-6100
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09104200208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0299197Medicaid
NJ0299197Medicaid