Healthcare Provider Details

I. General information

NPI: 1083684252
Provider Name (Legal Business Name): JOSEPH A GRECO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 W CYPRESS ST
KENNETT SQUARE PA
19348-2419
US

IV. Provider business mailing address

731 W CYPRESS ST
KENNETT SQUARE PA
19348-2419
US

V. Phone/Fax

Practice location:
  • Phone: 610-444-7550
  • Fax: 610-444-4656
Mailing address:
  • Phone: 610-444-7550
  • Fax: 610-444-4656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberMD050979L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD050979L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: