1770557027 NPI number — DR. PAUL M GREIF M.D.

Table of content: DR. PAUL M GREIF M.D. (NPI 1770557027)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770557027 NPI number — DR. PAUL M GREIF M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GREIF
Provider First Name:
PAUL
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1770557027
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7426 SPRAGUE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19119-1036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-204-9735
Provider Business Mailing Address Fax Number:
866-800-5572

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7426 SPRAGUE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19119-1036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-204-9735
Provider Business Practice Location Address Fax Number:
866-800-5572
Provider Enumeration Date:
02/14/2006

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: 207RP1001X , with the licence number:  034821 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RC0200X , with the licence number: 034821 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RS0012X , with the licence number: 034821 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 010034821CT03 . This is a "ANTHEM PROVIDER #" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 4049483 . This is a "AETNA PROVIDER #" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 290014327 . This is a "RAILROAD MEDICARE #" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 2V0751 . This is a "HEALTHNET PROVIDER #" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 4989290 . This is a "CIGNA PROVIDER #" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 9711490 . This is a "MASHANTUCKET PROVIDER #" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 004243276 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 061637053 . This is a "UNITED HEALTHCARE #" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P391774 . This is a "OXFORD PROVIDER #" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 741876 . This is a "CONNECTICARE PROVIDER #" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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