MEDICARE: DR. TRICIA DANIELLE GREENE 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
1	208800000X	Urology Physician	4301516486	MI
2	208800000X	Urology Physician	243505-1	NY

General Provider Information

NPI Number	:	1801090576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRICIA DANIELLE GREENE M.D.

Provider Business Mailing Address
First Line	:	245 E 54TH ST
Second Line	:	2N
City	:	NEW YORK
State	:	NY
Zip	:	10022-4707
Country	:	US
Telephone Number	:	212-570-6800
Fax Number	:	212-861-7964

Provider Business Practice Location Address
First Line	:	245 E 54TH ST
Second Line	:	2N
City	:	NEW YORK
State	:	NY
Zip	:	10022-4707
Country	:	US
Telephone Number	:	212-570-6800
Fax Number	:	212-861-7964

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

Provider Enumeration Date	:	06/14/2007
Last Update Date	:	03/06/2026

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