Provider Demographics
NPI:1760586028
Name:DAUN, GRETA (MD)
Entity Type:Individual
Prefix:MS
First Name:GRETA
Middle Name:
Last Name:DAUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 VILLAGE LANE
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05201-9824
Mailing Address - Country:US
Mailing Address - Phone:212-360-7893
Mailing Address - Fax:212-348-7253
Practice Address - Street 1:1900 SECOND AVENUE
Practice Address - Street 2:9TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-360-7893
Practice Address - Fax:212-348-7253
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY134684207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
134684OtherNYS LIC #
B12684Medicare UPIN
UPINB12684Medicare PIN
134684OtherNYS LIC #