Provider Demographics
NPI:1821535220
Name:GRECO-TUREN, THEODORA (BSN,MSN)
Entity Type:Individual
Prefix:
First Name:THEODORA
Middle Name:
Last Name:GRECO-TUREN
Suffix:
Gender:F
Credentials:BSN,MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41413 MARGARET CT
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12569-7998
Mailing Address - Country:US
Mailing Address - Phone:845-372-3642
Mailing Address - Fax:
Practice Address - Street 1:41413 MARGARET CT
Practice Address - Street 2:
Practice Address - City:PLEASANT VALLEY
Practice Address - State:NY
Practice Address - Zip Code:12569-7998
Practice Address - Country:US
Practice Address - Phone:845-372-3642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY449981-1172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker