Provider Demographics
NPI:1598050155
Name:GROFF, JAMES LEO (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LEO
Last Name:GROFF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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 STREET
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:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-12
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2961082086S0127X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Single Specialty