Provider Demographics
NPI:1114077963
Name:GRIFFITHS DOCKERY, DOROTHY LOUISE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:LOUISE
Last Name:GRIFFITHS DOCKERY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DOROTHY
Other - Middle Name:LOUISE
Other - Last Name:GRIFFITHS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:36 W 11TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011
Mailing Address - Country:US
Mailing Address - Phone:212-228-2471
Mailing Address - Fax:212-422-5171
Practice Address - Street 1:36 W 11TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011
Practice Address - Country:US
Practice Address - Phone:212-228-2471
Practice Address - Fax:212-422-5171
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0087241103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY144452OtherVALUE OPTIONS
NYV59611Medicare ID - Type Unspecified