Provider Demographics
NPI:1801805759
Name:GRIFFIN, EVE PATRICIA (MD)
Entity type:Individual
Prefix:DR
First Name:EVE
Middle Name:PATRICIA
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EVE
Other - Middle Name:PATRICIA
Other - Last Name:LUDEMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8 DORY CT
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-7738
Mailing Address - Country:US
Mailing Address - Phone:516-541-2358
Mailing Address - Fax:631-853-3493
Practice Address - Street 1:1869 BRENTWOOD ROAD
Practice Address - Street 2:BRENTWOOD HEALTH CENTER
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717
Practice Address - Country:US
Practice Address - Phone:631-853-3400
Practice Address - Fax:631-853-3493
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14360101207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB78801Medicare UPIN
07F48Medicare ID - Type Unspecified