MEDICARE: DR. EDWARD A GRIGGS JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	134705	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C10282	OTHER	NY	UPIN
2	134705	OTHER	NY	LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457332587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD A GRIGGS JR. M.D.

Provider Business Mailing Address
First Line	:	45 LUDLOW ST
Second Line	:	SUITE 516
City	:	YONKERS
State	:	NY
Zip	:	10705-1947
Country	:	US
Telephone Number	:	914-963-3322
Fax Number	:	914-963-3355

Provider Business Practice Location Address
First Line	:	45 LUDLOW ST
Second Line	:	SUITE 516
City	:	YONKERS
State	:	NY
Zip	:	10705-1947
Country	:	US
Telephone Number	:	914-963-3322
Fax Number	:	914-963-3355

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	03/07/2023

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