Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 204792 | NY |
NPI | 1013943919 |
---|---|
Provider Name | Dr. Todd R Griffin |
First Address | Stony Brook, NY 11790-0989 |
Second Address | East Setauket, NY 11733-4047 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02310589 | (05) | NY |
542E62 | EMPIRE BC.BS (01) | NY |
7801161 | AETNA (01) | NY |
H17219 | (02) | NY |