Provider Demographics
NPI:1700986486
Name:GRAESSLE, WILLIAM R (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:GRAESSLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3 COOPER PLZ
Mailing Address - Street 2:SUITE 502
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-968-7433
Mailing Address - Fax:
Practice Address - Street 1:3 COOPER PLZ
Practice Address - Street 2:SUITE 200
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1438
Practice Address - Country:US
Practice Address - Phone:856-342-2472
Practice Address - Fax:856-968-8414
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2016-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA58118208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ500518OtherAETNA
NJCA0000316OtherAMERIHCOICE
NJ1008870OtherHORIZON NJ HEALTH
NJ1152393OtherHORIZON NJ HEALTH
NJ1260910OtherUNITED HEALTHCARE
NJ25379OtherUNIVERISITY HEALTH PLAN
NJ60000654OtherHORIZON NJ HEALTH
NJ0186415000OtherAMERIHEALTH HMO/KEYSTONE/IBC
NJ3K5966OtherHEALTHNET
NJP1256293OtherOXFORD
NJ409870OtherAMERIHEALTH PPO/PA BS
NJ6276105Medicaid
NJ5550776OtherCIGNA
NJ60036241OtherHORIZON NJ HEALTH
NJ60000654OtherHORIZON NJ HEALTH
NJ60036241OtherHORIZON NJ HEALTH