Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Marvin Graham, CRNA

Individual provider Anesthesiology Physician · NPI 1669930178

Mr. Marvin Graham, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in New London, Connecticut. Qualified in 2018, 8 years ago. Practices with Northeast Medical Group Inc, a 1,360-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
8
Licensed in
CT
In the registry since
2019
Specialties on file
2
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

365 Montauk Ave
New London, CT 06320-4700
Phone: (860) 442-0711
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 8114 (CT)
Anesthesiology Physician Taxonomy 207L00000X · Licence 8114 (CT)

Record details

NPI number1669930178
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedMarch 5, 2019
Last updated in NPPESDecember 21, 2021
Certification dateDecember 21, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Northeast Medical Group Inc — 1360 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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