Provider Demographics
NPI:1730533589
Name:GREENE, ORIN S (AGNP-C, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ORIN
Middle Name:S
Last Name:GREENE
Suffix:
Gender:M
Credentials:AGNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 N ST NW STE 1
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-2827
Mailing Address - Country:US
Mailing Address - Phone:202-455-6395
Mailing Address - Fax:202-851-5052
Practice Address - Street 1:1717 N ST NW STE 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-2827
Practice Address - Country:US
Practice Address - Phone:202-455-6395
Practice Address - Fax:202-851-5052
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR207930363LA2200X, 363LP0808X
DCNP1031475363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health