Provider Demographics
NPI:1457687113
Name:GRIFFITH, ELVIN LAVERN (MD)
Entity Type:Individual
Prefix:
First Name:ELVIN
Middle Name:LAVERN
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ELVIN
Other - Middle Name:LAVERN
Other - Last Name:GRIFFITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:170 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-6054
Mailing Address - Country:US
Mailing Address - Phone:203-859-5154
Mailing Address - Fax:203-859-5662
Practice Address - Street 1:377 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516
Practice Address - Country:US
Practice Address - Phone:203-859-5154
Practice Address - Fax:203-859-5662
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-29
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT48211207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine