Healthcare Provider Details

I. General information

NPI: 1679428544
Provider Name (Legal Business Name): IODELLE EMPENZI GREAVES RN, AAS, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1358 56TH ST
BROOKLYN NY
11219-4616
US

IV. Provider business mailing address

655 UNION ST APT 11B
BROOKLYN NY
11215-7763
US

V. Phone/Fax

Practice location:
  • Phone: 718-854-0048
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number601150
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: