Basic Information
| Provider Information | |||||||||
| NPI: | 1326040874 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | GRIFFEL | ||||||||
| FirstName: | MARTIN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | STONY BROOK UNIVERSITY ANESTHESIOLOGY | ||||||||
| Address2: | HEALTH SCIENCE CENTER LEVEL 4 #060 | ||||||||
| City: | STONY BROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117948480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314442975 | ||||||||
| FaxNumber: | 6314442907 | ||||||||
| Practice Location | |||||||||
| Address1: | STONY BROOK UNIVERSITY ANESTHESIOLOGY | ||||||||
| Address2: | HEALTH SCIENCE CENTER LEVEL 4 #060 | ||||||||
| City: | STONY BROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117948480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314442975 | ||||||||
| FaxNumber: | 6314442907 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2005 | ||||||||
| LastUpdateDate: | 10/01/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 147398 | NY | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 01334945 | 05 | NY | MEDICAID |