Provider Demographics
NPI:1467662098
Name:BROWN-GREANEY, ROSETTA M (NP)
Entity Type:Individual
Prefix:
First Name:ROSETTA
Middle Name:M
Last Name:BROWN-GREANEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:342 WOODWORTH RD
Mailing Address - Street 2:
Mailing Address - City:HORNELL
Mailing Address - State:NY
Mailing Address - Zip Code:14843-9025
Mailing Address - Country:US
Mailing Address - Phone:607-871-2400
Mailing Address - Fax:607-871-2631
Practice Address - Street 1:19 PARK STREET
Practice Address - Street 2:
Practice Address - City:ALFRED
Practice Address - State:NY
Practice Address - Zip Code:14802-1232
Practice Address - Country:US
Practice Address - Phone:607-871-2400
Practice Address - Fax:607-871-2631
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY30-300796363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP78671Medicare UPIN