Provider Demographics
NPI:1659402030
Name:GRIECO, GIACINTO (MD)
Entity Type:Individual
Prefix:DR
First Name:GIACINTO
Middle Name:
Last Name:GRIECO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 LENOX CT
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-1809
Mailing Address - Country:US
Mailing Address - Phone:201-947-6599
Mailing Address - Fax:201-947-3511
Practice Address - Street 1:462 FIRST AVE - SEVENTH FLOOR
Practice Address - Street 2:NYU LANGONE HEALTH
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:11016
Practice Address - Country:US
Practice Address - Phone:646-501-6823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1349602084P0301X, 208M00000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084P0301XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBrain Injury Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC10705Medicare UPIN