Provider Demographics
NPI:1609533785
Name:GRIGGS, ENJAY TANEKA (BACHELOR OF PHARMACY)
Entity Type:Individual
Prefix:MS
First Name:ENJAY
Middle Name:TANEKA
Last Name:GRIGGS
Suffix:
Gender:F
Credentials:BACHELOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 VANDERBILT AVE FL 17
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-3829
Mailing Address - Country:US
Mailing Address - Phone:646-813-3001
Mailing Address - Fax:646-813-9488
Practice Address - Street 1:52 VANDERBILT AVE FL 17
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-3829
Practice Address - Country:US
Practice Address - Phone:646-813-3001
Practice Address - Fax:646-813-9488
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP045602L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist