MEDICARE: DR. MERVIN GRIFFIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	174172	FL
2	202D00000X	Integrative Medicine Physician	174172	FL
3	207P00000X	Emergency Medicine Physician	213359	NY
4	207P00000X	Emergency Medicine Physician	25MA08065400	NJ
5	2083A0300X	Addiction Medicine (Preventive Medicine) Physician	174172	FL
6	207P00000X	Emergency Medicine Physician	00024696	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00451724	OTHER	NJ	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	930118897	OTHER	AL	RRMC PROVIDER NUMBER
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	91002398002/NON PAR	OTHER	NJ	AMERICHOICE/KING
6	051509907	OTHER	AL	BCBS PROVIDER NUMBER

General Provider Information

NPI Number	:	1487636726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MERVIN GRIFFIN MD

Provider Business Mailing Address
First Line	:	20 LIVINGSTON AVE UNIT 401
Second Line	:
City	:	NEW BRUNSWICK
State	:	NJ
Zip	:	08901-1991
Country	:	US
Telephone Number	:	917-881-1223
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 LIVINGSTON AVE UNIT 401
Second Line	:
City	:	NEW BRUNSWICK
State	:	NJ
Zip	:	08901-1991
Country	:	US
Telephone Number	:	917-881-1223
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	10/23/2025

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