Provider Demographics
NPI:1992075717
Name:GREINER, MAGALY (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MAGALY
Middle Name:
Last Name:GREINER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-2407
Mailing Address - Country:US
Mailing Address - Phone:508-226-6035
Mailing Address - Fax:508-222-1877
Practice Address - Street 1:25 FOREST ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2407
Practice Address - Country:US
Practice Address - Phone:508-226-6035
Practice Address - Fax:508-222-1877
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6944235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA620733OtherTUFTS
MASG 0013OtherBLUE CROSS
MA626557OtherHARVARD PILGRIM
MA00876402OtherMEDICARE B