Individual
JUSTIN JAMES GREAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
180 BROADWAY, HICKSVILLE, NY 11801-4230
(516) 935-6858
Mailing address
180 BROADWAY, HICKSVILLE, NY 11801-4230
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
03/20/2019
Last updated
03/20/2019
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