Provider Demographics
NPI:1235890815
Name:JAMES GROFF MEDICAL P.C.
Entity Type:Organization
Organization Name:JAMES GROFF MEDICAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LEO
Authorized Official - Last Name:GROFF
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:631-919-5205
Mailing Address - Street 1:9 SHAWNEE ST
Mailing Address - Street 2:
Mailing Address - City:HAMPTON BAYS
Mailing Address - State:NY
Mailing Address - Zip Code:11946-1741
Mailing Address - Country:US
Mailing Address - Phone:631-538-8688
Mailing Address - Fax:
Practice Address - Street 1:2454 MAIN ST
Practice Address - Street 2:
Practice Address - City:BRIDGEHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11932
Practice Address - Country:US
Practice Address - Phone:631-919-5205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Single Specialty