Provider Demographics
NPI:1093715575
Name:GREENE, DARIUS B (DO)
Entity Type:Individual
Prefix:MR
First Name:DARIUS
Middle Name:B
Last Name:GREENE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4230 HEMPSTEAD TPKE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-5700
Mailing Address - Country:US
Mailing Address - Phone:516-735-3030
Mailing Address - Fax:516-735-3285
Practice Address - Street 1:4230 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE 205
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-5700
Practice Address - Country:US
Practice Address - Phone:516-735-3030
Practice Address - Fax:516-735-3285
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY159223207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00895294Medicaid
NY45D111Medicare PIN
D91808Medicare UPIN