Healthcare Provider Details

I. General information

NPI: 1306343157
Provider Name (Legal Business Name): HARRY RICHARD GRIFFIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2018
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST
BOSTON MA
02114-2696
US

IV. Provider business mailing address

1 HOSPITAL PLZ
STAMFORD CT
06902-3602
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-8320
  • Fax:
Mailing address:
  • Phone: 203-276-7467
  • Fax: 203-276-7020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number295370
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number295370
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: