Basic Information
Provider Information
NPI: 1699974741
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GRIFFIN
FirstName: ANNE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: O.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 235 WASHINGTON ST
Address2:  
City: SARATOGA SPRINGS
State: NY
PostalCode: 128665962
CountryCode: US
TelephoneNumber: 5185875900
FaxNumber: 5185875938
Practice Location
Address1: 235 WASHINGTON ST
Address2:  
City: SARATOGA SPRINGS
State: NY
PostalCode: 128665962
CountryCode: US
TelephoneNumber: 5185875900
FaxNumber: 5185875938
Other Information
ProviderEnumerationDate: 07/17/2007
LastUpdateDate: 09/28/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000XTUV007170-1NYY Eye and Vision Services ProvidersOptometrist 

No ID Information.


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