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Individual
MISS JOLENE RENEE GRIFFITH
Active
Individual
MISS JOLENE RENEE GRIFFITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
011350
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00028076902
UNIVERA
—
01
—
000529329002
BLUE CROSS
NY
01
—
9514304
IHA
NY
Enumeration date
08/22/2006
Last updated
03/29/2012
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