Badri Anthony Gravesande, PA

Primary specialty

Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X

License

003899 Issued in NY

Practice address

75 Vanderbilt Ave
Staten Island, NY 10304-2604

Phone

(718) 818-5638

NPI assigned

Oct 13, 2010

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286928000000",
    "number": "1245540178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 VANDERBILT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103042604",
            "telephone_number": "718-818-5638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 VANDERBILT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103042604",
            "telephone_number": "718-818-5638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVESANDE",
        "first_name": "BADRI",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-13",
        "last_updated": "2010-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "003899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Elysha Rand Grauman, PA
• Brianna N Gravagna
• Nichole Francine Graves-McLeod, LMSW
• Juanita Gray
• Lori Jill Gray, M.S.ED.
• Natasha W Gray, RN
• Alla S Grayfer
• Murray A. Grayson, R.PH.

• Addiction (Substance Use Disorder) Psychologist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Addiction (Substance Use Disorder) Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.