Provider Demographics
NPI:1881662567
Name:GRECO, JOSEPH P (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:P
Last Name:GRECO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:521 ASH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18509-2909
Mailing Address - Country:US
Mailing Address - Phone:570-344-2244
Mailing Address - Fax:570-344-1226
Practice Address - Street 1:521 ASH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18509-2909
Practice Address - Country:US
Practice Address - Phone:570-344-2244
Practice Address - Fax:570-344-1226
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD044285L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001241180Medicaid
PA001241180Medicaid
PAE77803Medicare UPIN