Healthcare Provider Details

I. General information

NPI: 1992523328
Provider Name (Legal Business Name): GREENE PHARMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2024
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 JEFFERSON HTS STE B201
CATSKILL NY
12414-1237
US

IV. Provider business mailing address

159 JEFFERSON HTS STE B201
CATSKILL NY
12414-1237
US

V. Phone/Fax

Practice location:
  • Phone: 518-943-1715
  • Fax: 518-943-4816
Mailing address:
  • Phone: 518-943-1715
  • Fax: 518-943-4816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SRINIVAS VELESETTY
Title or Position: SUPERVISING PHARMACIST
Credential:
Phone: 518-943-1715