Provider Demographics
NPI:1154568384
Name:THE GRIFFIN HOSPITAL
Entity type:Organization
Organization Name:THE GRIFFIN HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-732-7513
Mailing Address - Street 1:350 SEYMOUR AVE
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:CT
Mailing Address - Zip Code:06418-1338
Mailing Address - Country:US
Mailing Address - Phone:203-732-1260
Mailing Address - Fax:203-732-1194
Practice Address - Street 1:350 SEYMOUR AVE
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:CT
Practice Address - Zip Code:06418-1338
Practice Address - Country:US
Practice Address - Phone:203-732-1260
Practice Address - Fax:203-732-1194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0034261QX0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation