Provider Demographics
NPI:1134236326
Name:GRIFFITH, KATHLEEN
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MORRISTOWN MEDICAL CENTER
Mailing Address - Street 2:100 MADISON AVENUE
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960
Mailing Address - Country:US
Mailing Address - Phone:973-971-5132
Mailing Address - Fax:973-586-1916
Practice Address - Street 1:356 ROUTE 46 E
Practice Address - Street 2:
Practice Address - City:MOUNTAIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07046-1717
Practice Address - Country:US
Practice Address - Phone:844-362-1735
Practice Address - Fax:973-290-7495
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC05042000363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S76056Medicare UPIN
025479QEEMedicare ID - Type Unspecified