Provider Demographics
NPI:1720859515
Name:JAMES GREICO P.T.,M.S.
Entity Type:Organization
Organization Name:JAMES GREICO P.T.,M.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:GREICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-277-6673
Mailing Address - Street 1:55 CARLETON AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:EAST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11730-2133
Mailing Address - Country:US
Mailing Address - Phone:631-277-6673
Mailing Address - Fax:631-277-6606
Practice Address - Street 1:55 CARLETON AVE STE 5
Practice Address - Street 2:
Practice Address - City:EAST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11730-2133
Practice Address - Country:US
Practice Address - Phone:631-277-6673
Practice Address - Fax:631-277-6606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty