Healthcare Provider Details

I. General information

NPI: 1770557027
Provider Name (Legal Business Name): PAUL M GREIF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 03/07/2023
Certification Date: 03/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7426 SPRAGUE ST
PHILADELPHIA PA
19119-1036
US

IV. Provider business mailing address

7426 SPRAGUE ST
PHILADELPHIA PA
19119-1036
US

V. Phone/Fax

Practice location:
  • Phone: 860-204-9735
  • Fax: 866-800-5572
Mailing address:
  • Phone: 860-204-9735
  • Fax: 866-800-5572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number034821
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number034821
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number034821
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: