Provider Demographics
NPI:1760856389
Name:GRIFFITHS-THOMPSON, BRADLEY PATRICIA (LPN)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:PATRICIA
Last Name:GRIFFITHS-THOMPSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 ROUSSEAU DR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-4120
Mailing Address - Country:US
Mailing Address - Phone:585-409-8274
Mailing Address - Fax:585-341-4220
Practice Address - Street 1:980 ROUSSEAU DR
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-4120
Practice Address - Country:US
Practice Address - Phone:585-409-8274
Practice Address - Fax:585-341-4220
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306910164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse