Provider Demographics
NPI:1770686867
Name:GRECO, JOHN S JR (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:S
Last Name:GRECO
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 7400
Mailing Address - Street 2:JOHN S GRECO JR MD PA
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-7400
Mailing Address - Country:US
Mailing Address - Phone:732-741-7997
Mailing Address - Fax:732-741-8746
Practice Address - Street 1:130 MAPLE AVENUE
Practice Address - Street 2:BLDG #4 SUITE 4B
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1729
Practice Address - Country:US
Practice Address - Phone:732-741-7997
Practice Address - Fax:732-741-8746
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2016-07-05
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05895200207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5994209Medicaid
NJ501110Medicare ID - Type Unspecified
NJ5994209Medicaid