1871615609 NPI number — MS. ROSEMARIE GAMBALE GREENE ROSEMARIE GREENE

Table of content: MS. ROSEMARIE GAMBALE GREENE ROSEMARIE GREENE (NPI 1871615609)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871615609 NPI number — MS. ROSEMARIE GAMBALE GREENE ROSEMARIE GREENE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GREENE
Provider First Name:
ROSEMARIE
Provider Middle Name:
GAMBALE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ROSEMARIE GREENE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GREENE
Provider Other First Name:
ROSEMARIE
Provider Other Middle Name:
G.
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
ROSEMARIE GREENE
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1871615609
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
70 E 10TH ST
Provider Second Line Business Mailing Address:
APT 11U
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10003-5102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-473-8283
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
80 E 11TH ST
Provider Second Line Business Practice Location Address:
ROOM 434
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10003-6811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-886-0953
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/04/2007

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: 1041C0700X , with the licence number:  R054655-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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