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General NPI Number Information
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NPI Number | 1194548099
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Entity Type | Organization
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Legal Business Name | ISLAND INFECTIOUS DISEASE MEDICAL PLLC
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 11/17/2024
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Provider Practice Location Address
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Address Line | 23 MURRAY AVE
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-3502
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Country | US
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Telephone | 347-276-6116
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Fax | 347-276-6116
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Provider Business Mailing Address
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Address Line | 23 MURRAY AVE
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-3502
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Country | US
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Telephone | 347-276-6116
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Fax | 347-276-6116
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIEL GRIFFIN
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Credential | MD
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Telephone | 347-276-6116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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