Provider Demographics
NPI:1821008145
Name:GREENE, CAROLINE ANN (NP)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:ANN
Last Name:GREENE
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:425 E 61ST ST FL 11
Mailing Address - Street 2:WEILL CORNELL MEDICAL COLLEGE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8722
Mailing Address - Country:US
Mailing Address - Phone:212-821-0710
Mailing Address - Fax:212-821-0959
Practice Address - Street 1:170 W 12TH ST
Practice Address - Street 2:ST VINCENTS HOSPITAL DEPT OF COMMUNITY MEDICINE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8202
Practice Address - Country:US
Practice Address - Phone:212-604-2708
Practice Address - Fax:212-604-7627
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2013-07-15
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Provider Licenses
StateLicense IDTaxonomies
NYF303209363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02734150Medicaid
NY02734150Medicaid
Q64937Medicare UPIN