Provider Demographics
NPI:1699058297
Name:PALLITHANAM, GREENA SCARIA (NP)
Entity type:Individual
Prefix:
First Name:GREENA
Middle Name:SCARIA
Last Name:PALLITHANAM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3902 RIVERS RUN DR
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-8775
Mailing Address - Country:US
Mailing Address - Phone:614-352-2699
Mailing Address - Fax:
Practice Address - Street 1:3902 RIVERS RUN DR
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-8775
Practice Address - Country:US
Practice Address - Phone:614-352-2699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12568-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily