Provider Demographics
NPI:1922114602
Name:GRIFFITH, JOLENE RENEE (RPA-C)
Entity Type:Individual
Prefix:MISS
First Name:JOLENE
Middle Name:RENEE
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:RPA-C
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Mailing Address - Street 1:1815 SOUTH CLINTON AVENUE
Mailing Address - Street 2:STE 610
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618
Mailing Address - Country:US
Mailing Address - Phone:585-244-3430
Mailing Address - Fax:585-244-3165
Practice Address - Street 1:1815 SOUTH CLINTON AVE
Practice Address - Street 2:SUITE 610
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-244-3430
Practice Address - Fax:585-244-3165
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2012-03-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY011350363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
00028076902OtherUNIVERA
NY9514304OtherIHA
NY000529329002OtherBLUE CROSS
00028076902OtherUNIVERA