Provider Demographics
NPI:1538382155
Name:GREENE, CHIPO NATASHA (RN)
Entity type:Individual
Prefix:
First Name:CHIPO
Middle Name:NATASHA
Last Name:GREENE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CHIPO
Other - Middle Name:
Other - Last Name:GREENE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:2801 BEVERLEY RD
Mailing Address - Street 2:APT. 6A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-5556
Mailing Address - Country:US
Mailing Address - Phone:718-938-4947
Mailing Address - Fax:
Practice Address - Street 1:175 LAWRENCE AVE
Practice Address - Street 2:UCP
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-1102
Practice Address - Country:US
Practice Address - Phone:718-437-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY522742163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse