Provider Demographics
NPI:1588808653
Name:GREENE, AMY JANE (EDD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:JANE
Last Name:GREENE
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 QUAIL RUN
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14903-9307
Mailing Address - Country:US
Mailing Address - Phone:607-562-3043
Mailing Address - Fax:
Practice Address - Street 1:63 QUAIL RUN
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14903-9307
Practice Address - Country:US
Practice Address - Phone:607-562-3043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1499998174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist