Healthcare Provider Details

I. General information

NPI: 1114032521
Provider Name (Legal Business Name): WENDY A GRIFFITH-REECE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 09/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14524 230TH ST
SPRINGFIELD GARDENS NY
11413-3927
US

IV. Provider business mailing address

14524 230TH ST
SPRINGFIELD GARDENS NY
11413-3927
US

V. Phone/Fax

Practice location:
  • Phone: 718-712-6886
  • Fax: 718-712-2346
Mailing address:
  • Phone: 718-712-6886
  • Fax: 718-712-2346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number163568
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: