Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N0003930 | NY |
NPI | 1174509384 |
---|---|
Provider Name | Dr. William Greco |
First Address | Montvale, NJ 07645-2609 |
Second Address | New City, NY 10956-4305 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2005 |
Last Update Date | 12/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T51308 | (02) | NY |