Healthcare Provider Details

I. General information

NPI: 1114004025
Provider Name (Legal Business Name): GREER JULIEN SLOVIN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 OAK ST
COPIAGUE NY
11726-3111
US

IV. Provider business mailing address

12 JERSEY ST
DEER PARK NY
11729-2327
US

V. Phone/Fax

Practice location:
  • Phone: 631-691-7080
  • Fax: 631-691-3387
Mailing address:
  • Phone: 631-243-3876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number074156
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: