Provider Demographics
NPI:1528856044
Name:SECOND OPINION PHD LLC
Entity type:Organization
Organization Name:SECOND OPINION PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, APN, PHD
Authorized Official - Phone:414-719-5305
Mailing Address - Street 1:1136 NORIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53074-1365
Mailing Address - Country:US
Mailing Address - Phone:414-719-5305
Mailing Address - Fax:414-719-5305
Practice Address - Street 1:1136 NORIDGE TRL
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:WI
Practice Address - Zip Code:53074-1365
Practice Address - Country:US
Practice Address - Phone:414-719-5305
Practice Address - Fax:414-719-5305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty