Provider Demographics
NPI:1265437693
Name:GRIFFITH, ALBERT ROGER (EDD)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:ROGER
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 EVERETT PL
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-1660
Mailing Address - Country:US
Mailing Address - Phone:291-568-3467
Mailing Address - Fax:
Practice Address - Street 1:17 ACADEMY ST
Practice Address - Street 2:STE 908
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-2928
Practice Address - Country:US
Practice Address - Phone:973-624-4315
Practice Address - Fax:973-624-0012
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100149000103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist