Healthcare Provider Details

I. General information

NPI: 1861469991
Provider Name (Legal Business Name): CEABERT J GRIFFITH PA-C, N.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 557 BOX 2873
FPO AP
96379
JP

IV. Provider business mailing address

PSC 557 BOX 2873
FPO AP
96379
JP

V. Phone/Fax

Practice location:
  • Phone: 011816117453910
  • Fax:
Mailing address:
  • Phone: 011816117453910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNAT1000561
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number002478
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: