Doctor Name: | MR. CHARLES GRECO |
NPI Number: | 1669561635 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW-R,BCD |
License Number: | PR022710 |
Business Practice Address: | 37 Randall Rd Po 32 Wading River, NY - 11792 |
Business Phone Number: | 6319291400 |
Business Fax Number: | 6319291400 |
Mailing Address: | 4 Joann Court, P.o. 827 EASTPORT |
State: | NY |
Postal Code: | 11941 |
Phone Number: | 6319291400 |
Fax Number: | 6319291400 |
NPI Enumeration Date: | 10/11/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | PR022710 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |