Individual
KIM S GRISWOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
155 LAWN AVE, NORTHWEST BUFFALO COMMUNITY HEALTH CARE CENTER, BUFFALO, NY 14207
(716) 875-2904
(716) 875-6717
Mailing address
155 LAWN AVE, NORTHWEST BUFFALO COMMUNITY HEALTH CARE CENTER, BUFFALO, NY 14207-1816
(716) 875-2904
(716) 875-6717
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2009871
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01762725
—
NY
Enumeration date
09/07/2005
Last updated
03/29/2012
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