Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | 187186 | NY |
Y | 207PE0004X | Emergency Medical Services | MD.205378 | LA |
NPI | 1073554010 |
---|---|
Provider Name | Dr. Gina Luisa Greco-Angelopoulos |
First Address | Lake Charles, LA 70605-5912 |
Second Address | Lake Charles, LA 70605-5912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 17/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F53347 | (02) |