Provider Demographics
NPI:1114032521
Name:GRIFFITH-REECE, WENDY A (MD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:A
Last Name:GRIFFITH-REECE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14524 230TH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11413-3927
Mailing Address - Country:US
Mailing Address - Phone:718-712-6886
Mailing Address - Fax:718-712-2346
Practice Address - Street 1:14524 230TH ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11413-3927
Practice Address - Country:US
Practice Address - Phone:718-712-6886
Practice Address - Fax:718-712-2346
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2017-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY163568207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000911151Medicaid
NYD47445Medicare UPIN
NY000911151Medicaid