Healthcare Provider Details

I. General information

NPI: 1013433044
Provider Name (Legal Business Name): DANIEL GREENE LCSWR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

377 HIGHLAND AVE
BUFFALO NY
14223-1528
US

IV. Provider business mailing address

PO BOX 156
BUFFALO NY
14223-0156
US

V. Phone/Fax

Practice location:
  • Phone: 716-803-9491
  • Fax:
Mailing address:
  • Phone: 716-803-9491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number00039692
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: