Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME140101 | FL |
NPI | 1437569142 |
---|---|
Provider Name | Dr. Preston Grieco |
First Address | Brooklyn, NY 11203-2012 |
Second Address | Weston, FL 33331-3609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2014 |
Last Update Date | 21/05/2020 |