Provider Demographics
NPI:1528228145
Name:LANCE GREIFF
Entity Type:Organization
Organization Name:LANCE GREIFF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:I
Authorized Official - Last Name:GREIFF
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-601-2100
Mailing Address - Street 1:3333 HENRY HUDSON PKWY
Mailing Address - Street 2:3
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3224
Mailing Address - Country:US
Mailing Address - Phone:718-601-2100
Mailing Address - Fax:718-601-1915
Practice Address - Street 1:3333 HENRY HUDSON PKWY
Practice Address - Street 2:3
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3224
Practice Address - Country:US
Practice Address - Phone:718-601-2100
Practice Address - Fax:718-601-1915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004806-1213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5944170001Medicare NSC
NYP54353Medicare PIN