Provider Demographics
NPI:1497293831
Name:GRIFFITH, TERSHA
Entity type:Individual
Prefix:
First Name:TERSHA
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 1:477 MADISON AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-5802
Mailing Address - Country:US
Mailing Address - Phone:917-688-2868
Mailing Address - Fax:
Practice Address - Street 1:1 PENN PLAZA
Practice Address - Street 2:8TH FL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10119
Practice Address - Country:US
Practice Address - Phone:212-216-6400
Practice Address - Fax:212-216-6606
Is Sole Proprietor?:No
Enumeration Date:2017-02-06
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307756-1364SG0600X
NY307756-01363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology