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NPI Code Detail

MEDICARE: JENNIFER ANNE GRECO M.D.

MEDICARE: JENNIFER ANNE GRECO M.D.
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
1174400000XSpecialist241007NY

General Provider Information

NPI Number : 1104808104
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER ANNE GRECO M.D.
Provider Business Mailing Address
First Line : 1985 CROMPOND RD BLDG D
Second Line :
City : CORTLANDT MANOR
State : NY
Zip : 10567-4146
Country : US
Telephone Number : 914-788-8020
Fax Number : 914-788-8023
Provider Business Practice Location Address
First Line : 1980 CROMPOND RD
Second Line :
City : CORTLANDT MANOR
State : NY
Zip : 10567-4144
Country : US
Telephone Number : 914-788-8020
Fax Number : 914-788-8023
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2005
Last Update Date : 07/08/2007

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