Organization
GRIFFISS EC, LLC
Active
Parent organization
GRIFFISS EC, LLC
Other names
Griffiss ASC Anesthesia
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRIFFISS EC, LLC
Authorized official
PATRICK COSTELLO MD (AUTHORIZED OFFICIAL)
(315) 533-5747
Entity
Organization
Contact information
Practice address
105 DART CIR, ROME, NY 13441-4229
(315) 533-5747
Mailing address
PO BOX 2005, EAST SYRACUSE, NY 13057-4505
(315) 362-5129
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
12/04/2020
Last updated
12/04/2020
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