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General NPI Number Information
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NPI Number | 1912477605
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Entity Type | Organization
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Legal Business Name | QUALITY OF LIFE CLINIC LLC
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Dates
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Enumeration Date | 11/26/2018
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Last Update Date | 11/26/2018
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Provider Practice Location Address
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Address Line | 455 N END AVE
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City | NEW YORK
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State | NY
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Zip | 10282-1131
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Country | US
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Telephone | 212-791-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 200 W MAIN ST UNIT 307
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City | NEW ALBANY
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State | OH
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Zip | 43054-9370
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Country | US
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Telephone | 212-945-7252
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. STEVEN E GREER
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Credential | MD
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Telephone | 212-945-7252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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