MEDICARE: GRIFFIN FAMILY PRACTICE PA

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1902849250
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRIFFIN FAMILY PRACTICE PA

Provider Business Mailing Address
First Line	:	32427 LIGHTHOUSE RD
Second Line	:
City	:	SELBYVILLE
State	:	DE
Zip	:	19975-3408
Country	:	US
Telephone Number	:	302-436-9600
Fax Number	:	302-436-6260

Provider Business Practice Location Address
First Line	:	32427 LIGHTHOUSE RD
Second Line	:
City	:	SELBYVILLE
State	:	DE
Zip	:	19975-3408
Country	:	US
Telephone Number	:	302-436-9600
Fax Number	:	302-436-6260

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KRISTINE MARIE GRIFFIN
Credential	:	M.D.
Telephone Number	:	302-436-9600

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	09/30/2020

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