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NPI Code Detail

MEDICARE: DR. RICHARD THOMAS GRECO D.O.

MEDICARE: DR. RICHARD THOMAS GRECO D.O.
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
1207Q00000XFamily Medicine PhysicianMB074803NJ

General Provider Information

NPI Number : 1497730717
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD THOMAS GRECO D.O.
Provider Business Mailing Address
First Line : 3250 ZEMKE AVE BLDG 1078
Second Line :
City : TAMPA
State : FL
Zip : 33621-5023
Country : US
Telephone Number : 813-827-9714
Fax Number :
Provider Business Practice Location Address
First Line : 12033 AGENCY RD
Second Line :
City : PARKER
State : AZ
Zip : 85344-7718
Country : US
Telephone Number : 928-669-2137
Fax Number : 928-669-3131
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2005
Last Update Date : 08/05/2025

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