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General NPI Number Information
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NPI Number | 1174907547
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Entity Type | Organization
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Legal Business Name | WINTHROP FACULTY MEDICAL AFFILIATES UNIVERSITY FACULTY PRACTICE CORP
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Dates
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Enumeration Date | 07/16/2015
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Last Update Date | 07/16/2015
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Provider Practice Location Address
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Address Line | 259 1ST ST
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City | MINEOLA
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State | NY
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Zip | 11501-3957
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Country | US
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Telephone | 516-663-8963
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Fax |
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Provider Business Mailing Address
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Address Line | 222 STATION PLZ N 310
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City | MINEOLA
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State | NY
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Zip | 11501-3800
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Country | US
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Telephone | 516-663-4944
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Fax |
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Authorized Official
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Title or Position | CO-PRESIDENT
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Name | JOSEPH J GRECO
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Credential | MD
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Telephone | 516-663-2216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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