Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 252874 | NY |
NPI | 1003020041 |
---|---|
Provider Name | Margaret Grifa |
First Address | Rochester, NY 14626-1177 |
Second Address | Rochester, NY 14626-1177 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 29/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03123246 | (05) | NY |