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NPI 1790747459

NPI 1790747459 : ANN EZ GRIEPP MD : FAIRPORT, NY

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General NPI Number Information
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    NPI Number           |    1790747459
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    Entity Type          |    Individual 
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    Provider Name        |    ANN EZ GRIEPP MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/06/2006
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    Last Update Date     |    05/27/2022
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Provider Practice Location Address
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    Address Line         |    1387 FAIRPORT RD STE 650
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    City                 |    FAIRPORT
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    State                |    NY
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    Zip                  |    14450
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    Country              |    US
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    Telephone            |    585-388-8030
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1387 FAIRPORT RD STE 650
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    City                 |    FAIRPORT
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    State                |    NY
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    Zip                  |    14450
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    Country              |    US
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    Telephone            |    
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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        |    2084P0800X
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    Taxonomy Name        |    Psychiatry Physician
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    License Number       |    1671211
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    License Number State |    NY
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