Provider Demographics
NPI:1992746291
Name:GRECO, CAROL M (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:M
Last Name:GRECO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 TILBURY AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2517
Mailing Address - Country:US
Mailing Address - Phone:412-623-3023
Mailing Address - Fax:412-623-6414
Practice Address - Street 1:580 S AIKEN AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1531
Practice Address - Country:US
Practice Address - Phone:412-623-3023
Practice Address - Fax:412-623-6414
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006865L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAGR176383OtherHIGHMARK BLUE SHIELD
PAGR176383OtherHIGHMARK BLUE SHIELD