Provider Demographics
NPI:1841459922
Name:GREENE, YENEISHA (MD)
Entity type:Individual
Prefix:DR
First Name:YENEISHA
Middle Name:
Last Name:GREENE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:YENEISHA
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4201 WILSON BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22230
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4201 WILSON BOULEVARD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22230
Practice Address - Country:US
Practice Address - Phone:703-292-4401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-04
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD007129207QA0505X
DCMD039829207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine