Individual
LAUREN GRECO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3588 JAMES ST, BLASDELL, NY 14219-2555
(716) 319-0527
Mailing address
3588 JAMES ST, BLASDELL, NY 14219-2555
(716) 319-0527
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
010605-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010605-1
LICENSE #
NY
Enumeration date
09/01/2016
Last updated
09/01/2016
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