Provider Demographics
NPI:1801090576
Name:GREENE, TRICIA DANIELLE (MD)
Entity type:Individual
Prefix:DR
First Name:TRICIA
Middle Name:DANIELLE
Last Name:GREENE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:245 E 54TH ST
Mailing Address - Street 2:2N
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4707
Mailing Address - Country:US
Mailing Address - Phone:212-570-6800
Mailing Address - Fax:212-861-7964
Practice Address - Street 1:245 E 54TH ST
Practice Address - Street 2:2N
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4707
Practice Address - Country:US
Practice Address - Phone:212-570-6800
Practice Address - Fax:212-861-7964
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY243505-1208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400065396Medicare PIN
NJ136213BJLMedicare PIN