Provider Demographics
NPI:1174509384
Name:GRECO, WILLIAM (DPM)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:GRECO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:13 MURRAY RD
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-2609
Mailing Address - Country:US
Mailing Address - Phone:201-573-8440
Mailing Address - Fax:201-746-0455
Practice Address - Street 1:345 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-4305
Practice Address - Country:US
Practice Address - Phone:845-831-2000
Practice Address - Fax:201-746-0455
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN0003930213ES0131X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP41931Medicare PIN
NYT51308Medicare UPIN