Provider Demographics
NPI:1831477736
Name:ELVIN GRIFFITH, M.D. P.C.
Entity Type:Organization
Organization Name:ELVIN GRIFFITH, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELVIN
Authorized Official - Middle Name:LAVERN
Authorized Official - Last Name:GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-859-5154
Mailing Address - Street 1:377 MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-4311
Mailing Address - Country:US
Mailing Address - Phone:203-859-5154
Mailing Address - Fax:203-859-5662
Practice Address - Street 1:377 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-4311
Practice Address - Country:US
Practice Address - Phone:203-859-5154
Practice Address - Fax:203-859-5662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT048211207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty