Provider Demographics
NPI:1497994537
Name:GREENE, AMY LEE (MPT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LEE
Last Name:GREENE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 LINDEN RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-3804
Mailing Address - Country:US
Mailing Address - Phone:401-245-1845
Mailing Address - Fax:
Practice Address - Street 1:65 LINDEN RD
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-3804
Practice Address - Country:US
Practice Address - Phone:401-245-1845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16551225100000X
RIPT01712225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist