Provider Demographics
NPI:1659440444
Name:GRIFFIN, JOHN FRANCIS (PHYSICIAN)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FRANCIS
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:PHYSICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 IRVING AVENUE
Mailing Address - Street 2:SUITE 420
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210
Mailing Address - Country:US
Mailing Address - Phone:315-425-7722
Mailing Address - Fax:315-475-1705
Practice Address - Street 1:475 IRVING AVENUE
Practice Address - Street 2:SUITE 420
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-425-7722
Practice Address - Fax:315-475-1705
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108376207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00480391Medicaid
52072BMedicare PIN
56479BMedicare PIN
4411810883Medicare PIN