1841415262 NPI number — MS. DOREEN MARIA HERNANDEZ-GRECO LCSW, LCADC

Table of content: MS. DOREEN MARIA HERNANDEZ-GRECO LCSW, LCADC (NPI 1841415262)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841415262 NPI number — MS. DOREEN MARIA HERNANDEZ-GRECO LCSW, LCADC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HERNANDEZ-GRECO
Provider First Name:
DOREEN
Provider Middle Name:
MARIA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW, LCADC
Provider Gender Code:
F

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:
1841415262
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
450 ISLAND RD
Provider Second Line Business Mailing Address:
UNIT #40
Provider Business Mailing Address City Name:
RAMSEY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07446-1144
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-638-1586
Provider Business Mailing Address Fax Number:
201-962-2543

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
33-11 BROADWAY
Provider Second Line Business Practice Location Address:
SUITE #202
Provider Business Practice Location Address City Name:
FAIR LAWN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07410-4634
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-638-1586
Provider Business Practice Location Address Fax Number:
201-962-2543
Provider Enumeration Date:
04/13/2007

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: 101YA0400X , with the licence number:  37LC00068900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 44SC05294900 , 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)





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