Provider Demographics
NPI:1073837688
Name:GRECO, MICHELLE A (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:A
Last Name:GRECO
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 N STATE RD
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1415
Mailing Address - Country:US
Mailing Address - Phone:201-391-1966
Mailing Address - Fax:914-941-4381
Practice Address - Street 1:89 N STATE RD
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1415
Practice Address - Country:US
Practice Address - Phone:201-391-1966
Practice Address - Fax:914-941-4381
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041106-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist