Healthcare Provider Details

I. General information

NPI: 1598026494
Provider Name (Legal Business Name): YESENIA GREEFF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2012
Last Update Date: 08/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 MAIN ST STE 3A
SPRINGFIELD MA
01199
US

IV. Provider business mailing address

759 CHESTNUT ST # S2606
SPRINGFIELD MA
01199-1001
US

V. Phone/Fax

Practice location:
  • Phone: 413-794-7364
  • Fax: 413-794-7482
Mailing address:
  • Phone: 413-794-3570
  • Fax: 413-794-8828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number261501
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number261501
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: