Provider Demographics
NPI:1972000859
Name:GREENE, MELANIE
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:
Last Name:GREENE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 COURT ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-2012
Mailing Address - Country:US
Mailing Address - Phone:516-992-2778
Mailing Address - Fax:
Practice Address - Street 1:28 COURT ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-2012
Practice Address - Country:US
Practice Address - Phone:516-992-2778
Practice Address - Fax:516-992-2778
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist