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NPI Code Detail

MEDICARE: PATRICK GREENE

MEDICARE: PATRICK GREENE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor007072-01NY

General Provider Information

NPI Number : 1588934053
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK GREENE
Provider Business Mailing Address
First Line : 55 DODGE RD
Second Line :
City : GETZVILLE
State : NY
Zip : 14068-1205
Country : US
Telephone Number : 716-831-2700
Fax Number : 716-831-1818
Provider Business Practice Location Address
First Line : 1370 NIAGARA FALLS BLVD
Second Line :
City : TONAWANDA
State : NY
Zip : 14150-8431
Country : US
Telephone Number : 716-833-3792
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2011
Last Update Date : 02/02/2023

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Directions to “ PATRICK GREENE ” Practice Location

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