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NPI Code Detail

MEDICARE: MICHAEL GRIECO

MEDICARE: MICHAEL GRIECO
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
1225100000XPhysical Therapist043892-1NY

General Provider Information

NPI Number : 1780155150
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL GRIECO
Provider Business Mailing Address
First Line : 35 ORIOLE WAY
Second Line :
City : DIX HILLS
State : NY
Zip : 11746-4915
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 150 BAY SHORE RD
Second Line :
City : NORTH BABYLON
State : NY
Zip : 11703-1711
Country : US
Telephone Number : 631-586-6616
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2018
Last Update Date : 12/11/2018

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Directions to “ MICHAEL GRIECO ” Practice Location

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