Healthcare Provider Details

I. General information

NPI: 1174509384
Provider Name (Legal Business Name): WILLIAM GRECO DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 02/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 N MAIN ST
NEW CITY NY
10956-4305
US

IV. Provider business mailing address

13 MURRAY RD
MONTVALE NJ
07645-2609
US

V. Phone/Fax

Practice location:
  • Phone: 845-831-2000
  • Fax: 201-746-0455
Mailing address:
  • Phone: 201-573-8440
  • Fax: 201-746-0455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberN0003930
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: