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General NPI Number Information
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NPI Number | 1477622777
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Entity Type | Organization
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Legal Business Name | GRECO PHYSICAL THERAPY & SPORTS PERFORMANCE, PLLC
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 340 WHEATLEY PLZ
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City | GREENVALE
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State | NY
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Zip | 11548-1325
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Country | US
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Telephone | 516-621-2267
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Fax |
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Provider Business Mailing Address
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Address Line | 247 3RD ST
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City | SAINT JAMES
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State | NY
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Zip | 11780-2442
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. RICHARD GRECO
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Credential | PT
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Telephone | 516-621-2267
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 013485
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License Number State | NY
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