Individual
JOHN GRECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
33 ANN DR, SYOSSET, NY 11791-5906
(516) 238-6516
(952) 942-3361
Mailing address
33 ANN DR, SYOSSET, NY 11791-5906
(516) 238-6516
(952) 942-3361
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
166212
NY
208D00000X
General Practice Physician
Primary
166212
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01768661
—
NY
01
—
0232CC
MEDICARE GHI
NY
Enumeration date
06/12/2006
Last updated
05/27/2015
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