Provider Demographics
NPI:1487650016
Name:GRECO, JOSEPH M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:GRECO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3085 HARLEM RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-2563
Mailing Address - Country:US
Mailing Address - Phone:716-844-5600
Mailing Address - Fax:716-844-5750
Practice Address - Street 1:3085 HARLEM RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-2563
Practice Address - Country:US
Practice Address - Phone:716-844-5600
Practice Address - Fax:716-844-5750
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY125081208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00010067701OtherUNIVERA
NY1909182OtherIHA
NY000507772005OtherBCBS OF WNY
NY01417541Medicaid
NY1099969OtherGHI
NY125081-0OtherWORKERS COMP
NY040426000996OtherFIDELIS
NY1909182OtherIHA
NY040426000996OtherFIDELIS
NY340013069Medicare ID - Type UnspecifiedRR MEDICARE