Provider Demographics
NPI:1477567428
Name:GREELEY, NORMAN H (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:H
Last Name:GREELEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4701
Mailing Address - Country:US
Mailing Address - Phone:718-624-4465
Mailing Address - Fax:718-722-7483
Practice Address - Street 1:140 CLINTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4701
Practice Address - Country:US
Practice Address - Phone:718-624-4465
Practice Address - Fax:718-722-7483
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY151542207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY38D971Medicare ID - Type Unspecified
NYB14125Medicare UPIN