Provider Demographics
NPI:1912477605
Name:QUALITY OF LIFE CLINIC LLC
Entity Type:Organization
Organization Name:QUALITY OF LIFE CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:GREER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-945-7252
Mailing Address - Street 1:200 W MAIN ST UNIT 307
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-9370
Mailing Address - Country:US
Mailing Address - Phone:212-945-7252
Mailing Address - Fax:
Practice Address - Street 1:455 N END AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10282-1131
Practice Address - Country:US
Practice Address - Phone:212-791-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty