Provider Demographics
NPI:1972020691
Name:GRECO, LAUREN CHRISTINE (DPT)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:CHRISTINE
Last Name:GRECO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-1805
Mailing Address - Country:US
Mailing Address - Phone:516-867-2201
Mailing Address - Fax:
Practice Address - Street 1:1800 WALT WHITMAN RD
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-3099
Practice Address - Country:US
Practice Address - Phone:631-694-0005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041859225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist