Provider Demographics
NPI:1518635861
Name:GREENSTREET, DAWNING RED (RN)
Entity Type:Individual
Prefix:
First Name:DAWNING
Middle Name:RED
Last Name:GREENSTREET
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 W 125TH ST FRNT 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-4589
Mailing Address - Country:US
Mailing Address - Phone:212-609-7285
Mailing Address - Fax:
Practice Address - Street 1:148 W 125TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-4589
Practice Address - Country:US
Practice Address - Phone:212-609-7285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY648519163W00000X
NYF310998363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse