Healthcare Provider Details

I. General information

NPI: 1477567428
Provider Name (Legal Business Name): NORMAN H GREELEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 CLINTON ST
BROOKLYN NY
11201-4701
US

IV. Provider business mailing address

140 CLINTON ST
BROOKLYN NY
11201-4701
US

V. Phone/Fax

Practice location:
  • Phone: 718-624-4465
  • Fax: 718-722-7483
Mailing address:
  • Phone: 718-624-4465
  • Fax: 718-722-7483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number151542
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: