Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | ||
Y | 222Z00000X | Podiatrist | ||
N | 225000000X | Orthotic Fitter |
NPI | 1942440482 |
---|---|
Provider Name | Mr. John Robert Greiner |
First Address | Wilkes Barre, PA 18711-0030 |
Second Address | Wilkes Barre, PA 18711-0030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2009 |
Last Update Date | 24/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
222Z00000X | VA MEDICAL CENTER (01) | PA |
225000000X | VA MEDICAL CENTER (01) | PA |