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General NPI Number Information
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NPI Number | 1154482651
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Entity Type | Individual
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Provider Name | RICHARD A GREENE M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 21 HENRY AVE STE 2
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City | PITTSFIELD
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State | MA
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Zip | 01201-6722
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Country | US
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Telephone | 413-443-3472
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Fax | 413-443-8361
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Provider Business Mailing Address
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Address Line | 58 GOOSE POND RD
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City | LEE
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State | MA
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Zip | 01238-9277
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Country | US
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Telephone | 413-243-4637
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 46583
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License Number State | MA
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