Basic Information
Provider Information
NPI: 1497293831
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GRIFFITH
FirstName: TERSHA
MiddleName:  
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NameSuffix:  
Credential:  
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Mailing Information
Address1: 1 PENN PLAZA
Address2: 8TH FL
City: NEW YORK
State: NY
PostalCode: 10119
CountryCode: US
TelephoneNumber: 2122166400
FaxNumber: 2122166606
Practice Location
Address1: 1 PENN PLAZA
Address2: 8TH FL
City: NEW YORK
State: NY
PostalCode: 10119
CountryCode: US
TelephoneNumber: 2122166400
FaxNumber: 2122166606
Other Information
ProviderEnumerationDate: 02/06/2017
LastUpdateDate: 02/06/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
364SG0600X307756-1NYY Physician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology

No ID Information.


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