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General NPI Number Information
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NPI Number | 1902957335
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Entity Type | Organization
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Legal Business Name | KATHIET GREENE, MD, INC
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Dates
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Enumeration Date | 01/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 30575 EUCLID AVE
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City | WICKLIFFE
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State | OH
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Zip | 44092-1037
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Country | US
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Telephone | 440-516-3776
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Fax | 440-516-3783
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Provider Business Mailing Address
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Address Line | 30575 EUCLID AVE
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City | WICKLIFFE
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State | OH
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Zip | 44092-1037
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Country | US
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Telephone | 440-516-3776
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Fax | 440-516-3783
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Authorized Official
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Title or Position | PHYSICIAN
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Name | KATHIE GREENE
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Credential | M.D.
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Telephone | 440-516-3776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number | 35062093G
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License Number State | OH
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