Provider Demographics
NPI:1356861918
Name:GRECO, BRIELLE CAMILLE (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:BRIELLE
Middle Name:CAMILLE
Last Name:GRECO
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:640 S STATE ST, POB 3RD FLOOR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3530
Mailing Address - Country:US
Mailing Address - Phone:302-480-1688
Mailing Address - Fax:302-480-9807
Practice Address - Street 1:655 S BAY RD STE 1
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-4615
Practice Address - Country:US
Practice Address - Phone:302-730-4366
Practice Address - Fax:302-730-0231
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2018-01-30
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant