MEDICARE: MR. GERALD G. GRIFFITHS RPH.

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	183500000X	Pharmacist	25511	NY

General Provider Information

NPI Number	:	1740357094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GERALD G. GRIFFITHS RPH.

Provider Business Mailing Address
First Line	:	5 NASH RD
Second Line	:
City	:	NORTH SALEM
State	:	NY
Zip	:	10560-3710
Country	:	US
Telephone Number	:	914-234-3744
Fax Number	:	914-234-0652

Provider Business Practice Location Address
First Line	:	414 OLD POST RD
Second Line	:
City	:	BEDFORD
State	:	NY
Zip	:	10506-1018
Country	:	US
Telephone Number	:	914-234-3744
Fax Number	:	914-234-0652

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

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	07/08/2007

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