Provider Demographics
NPI:1386710663
Name:GRIFFIN-HANSRAJ, MARCIA DEE (DO)
Entity type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:DEE
Last Name:GRIFFIN-HANSRAJ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:243 NORTH ROAD
Mailing Address - Street 2:SUITE 202S
Mailing Address - City:POUQHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601
Mailing Address - Country:US
Mailing Address - Phone:845-471-9200
Mailing Address - Fax:845-471-1551
Practice Address - Street 1:243 NORTH ROAD
Practice Address - Street 2:SUITE 202S
Practice Address - City:POUQHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601
Practice Address - Country:US
Practice Address - Phone:845-471-9200
Practice Address - Fax:845-471-1551
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2252591208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI32624Medicare UPIN
NY1193J1Medicare ID - Type Unspecified