Provider Demographics
NPI:1134454143
Name:GRECO, EVA (PSYD)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:GRECO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 HIGHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAG HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11963-2907
Mailing Address - Country:US
Mailing Address - Phone:305-724-7220
Mailing Address - Fax:
Practice Address - Street 1:125 HIGHVIEW DR
Practice Address - Street 2:
Practice Address - City:SAG HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11963-2907
Practice Address - Country:US
Practice Address - Phone:305-724-7220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-08
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018315-1103TC0700X
NY018315103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical