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General NPI Number Information
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NPI Number | 1235492018
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER GRIECO, PSY.D., P.C.
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Dates
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Enumeration Date | 06/18/2012
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Last Update Date | 05/15/2014
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Provider Practice Location Address
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Address Line | 212 SOUTH ST
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City | OYSTER BAY
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State | NY
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Zip | 11771-2362
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Country | US
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Telephone | 516-384-9032
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Fax | 516-433-0471
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Provider Business Mailing Address
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Address Line | 212 SOUTH ST
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City | OYSTER BAY
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State | NY
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Zip | 11771-2362
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Country | US
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Telephone | 516-384-9032
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Fax | 516-433-0471
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. CHRISTOPHER EDWARD GRIECO
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Credential | PSY.D.
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Telephone | 516-384-9032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 015617-1
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License Number State | NY
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