Provider Demographics
NPI:1588035729
Name:GREGER, JACQUELINE MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:MARIE
Last Name:GREGER
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:101 NICOLLS ROAD
Mailing Address - Street 2:HSC T17-040
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8172
Mailing Address - Country:US
Mailing Address - Phone:631-444-3869
Mailing Address - Fax:631-444-7502
Practice Address - Street 1:101 NICOLLS RD STONY BROOK DEPT OF MEDICINE
Practice Address - Street 2:HSC, T17-040
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8350
Practice Address - Country:US
Practice Address - Phone:631-444-3869
Practice Address - Fax:631-444-7502
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2023-02-17
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Provider Licenses
StateLicense IDTaxonomies
NY018982363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant