Individual
NICOLE D GRECO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
71 HAYNES ST, MANCHESTER, CT 06040-4131
(860) 647-6459
(860) 533-2975
Mailing address
2422 TOWN BROOKE, MIDDLETOWN, CT 06457-6630
(516) 425-8583
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002135
CT
Other
Enumeration date
09/18/2008
Last updated
09/18/2008
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