1518968932 NPI number — DREW P GREELEY MD

Table of content: DREW P GREELEY MD (NPI 1518968932)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518968932 NPI number — DREW P GREELEY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GREELEY
Provider First Name:
DREW
Provider Middle Name:
P
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518968932
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 MADISON AVE
Provider Second Line Business Mailing Address:
MID ATLANTIC SURGICAL ASSOC
Provider Business Mailing Address City Name:
MORRISTOWN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07960-6136
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-971-7300
Provider Business Mailing Address Fax Number:
973-984-7019

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1944 ROUTE 33
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
NEPTUNE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07753-4862
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-776-4622
Provider Business Practice Location Address Fax Number:
732-776-3765
Provider Enumeration Date:
08/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208G00000X , with the licence number:  69174 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7987609 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com