MEDICARE: ADELE GREENE

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	172M00000X	Mechanotherapist	103031	NY

General Provider Information

NPI Number	:	1093090946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADELE GREENE

Provider Business Mailing Address
First Line	:	284 SUTTER AVE APT 5A
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212-6424
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 W 27TH ST STE 400
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10001-6241
Country	:	US
Telephone Number	:	212-206-7542
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2011
Last Update Date	:	10/11/2011

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Directions to “ ADELE GREENE ” Practice Location

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