MEDICARE: VALARIE C GRECO LCSW PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1033757497
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALARIE C GRECO LCSW PLLC

Provider Business Mailing Address
First Line	:	61 COMMERCE ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3207
Country	:	US
Telephone Number	:	917-297-5081
Fax Number	:

Provider Business Practice Location Address
First Line	:	2153 RICHMOND AVE STE 402B
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3935
Country	:	US
Telephone Number	:	917-297-5081
Fax Number	:

Authorized Official
Title or Position	:	EMPLOYEE
Name	:	VALARIE C GRECO
Credential	:	LCSW
Telephone Number	:	917-297-5081

Provider Enumeration Date	:	12/17/2019
Last Update Date	:	12/17/2019

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