Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 016133 | CT |
NPI | 1083718464 |
---|---|
Provider Name | Dr. Thomas Peter Greco |
First Address | Waterbury, CT 06706-1127 |
Second Address | Waterbury, CT 06706-1127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 02/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001161330 | (05) | CT |
C65041 | (02) | CT |