Provider Demographics
NPI:1003540709
Name:MURRAY, GRIFFIN (PA)
Entity Type:Individual
Prefix:
First Name:GRIFFIN
Middle Name:
Last Name:MURRAY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1150 YOUNGS RD STE 104
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-8096
Mailing Address - Country:US
Mailing Address - Phone:716-636-7979
Mailing Address - Fax:716-929-0192
Practice Address - Street 1:1150 YOUNGS RD STE 104
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8096
Practice Address - Country:US
Practice Address - Phone:716-636-7979
Practice Address - Fax:716-929-0192
Is Sole Proprietor?:No
Enumeration Date:2022-07-11
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY028425363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant