Healthcare Provider Details

I. General information

NPI: 1023123916
Provider Name (Legal Business Name): MARGARET LORETTA GREENWOOD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 06/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 MERCYCARE LANE
GUILDERLAND NY
12084
US

IV. Provider business mailing address

10 TERRACE PLACE
TROY NY
12180
US

V. Phone/Fax

Practice location:
  • Phone: 518-452-6760
  • Fax:
Mailing address:
  • Phone: 518-286-1503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF332331
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF400829
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: