Provider Demographics
NPI:1386742476
Name:GRIECO, ANTHONY J (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:GRIECO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 FIRST AVENUE
Mailing Address - Street 2:SUITE 4H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-263-7272
Mailing Address - Fax:212-263-8972
Practice Address - Street 1:530 FIRST AVENUE
Practice Address - Street 2:SUITE 4H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-263-7272
Practice Address - Fax:212-263-8972
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092570207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
898931Medicare ID - Type Unspecified
B95557Medicare UPIN