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General NPI Number Information
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NPI Number | 1386069169
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Entity Type | Individual
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Provider Name | STEPHEN GRIGGS NP
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Gender | Male
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Dates
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Enumeration Date | 03/03/2014
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Last Update Date | 03/03/2014
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Provider Practice Location Address
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Address Line | 2950 ELMWOOD AVE RM. 4014
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City | KENMORE
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State | NY
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Zip | 14217-1304
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Country | US
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Telephone | 716-447-6096
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Fax |
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Provider Business Mailing Address
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Address Line | 3645 LOWER MOUNTAIN RD
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City | SANBORN
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State | NY
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Zip | 14132-9114
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Country | US
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Telephone | 716-216-4263
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F306775-1
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License Number State | NY
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