Edmund Azeriah Griffin Jr., MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

239591 Issued in NY

Practice address

515 Madison Ave FL 21
New York, NY 10022-5433

Phone

(646) 863-4004

Fax

(646) 430-8950

NPI assigned

Jun 30, 2008

Last updated

Mar 6, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1811159064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225403",
            "telephone_number": "646-863-4004",
            "fax_number": "646-430-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MADISON AVE FL 21",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225433",
            "telephone_number": "646-863-4004",
            "fax_number": "646-430-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "EDMUND",
        "middle_name": "AZERIAH",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "239591",
            "primary": true
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NY",
            "license": "61-4784",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanda Griffin-Griffiths, LPN
• Aaron Timothy Griffin, MD, PHD
• Chanda Danielle Griffin, LCSW
• Cheryl Griffin
• Christine Mary Griffin, P.T.
• Emily Griffin, CGC
• Emily Paige Griffin, PT, DPT
• Erika M. Griffin, OTR/L
• Haley Erin Griffin, MD
• Jennifer Griffin, PA-C

• Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.