Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD050979L | PA |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | MD050979L | PA |
NPI | 1083684252 |
---|---|
Provider Name | Joseph A Greco |
First Address | Bryn Mawr, PA 19010-3129 |
Second Address | Bryn Mawr, PA 19010-3129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2006 |
Last Update Date | 03/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F79942 | (02) |