Jessic Miriam Greene, CTRS

Primary specialty

Recreation TherapistTaxonomy code 225800000X

License

57786 Issued in NU

Practice address

400 Sunrise Hwy
Amityville, NY 11701-2508

Phone

(631) 608-5547

NPI assigned

Apr 23, 2019

Last updated

Apr 23, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1710541008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SUNRISE HWY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012508",
            "telephone_number": "631-608-5547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SUNRISE HWY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012508",
            "telephone_number": "631-608-5547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "JESSIC",
        "middle_name": "MIRIAM",
        "credential": "CTRS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "NU",
            "license": "57786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica M Grady
• Michael Gramse, D.C.
• Sonya Grant
• Deborah Anne Green, ATR-BC
• Meredith Lyn Greenberg, LMSW
• Lee Greenman, LMSW,CASAC
• Patrick Greger
• Lashanda Griffin
• Dornet Marie Griffiths, RN
• Sabrina Grindley

• Recreation Therapist in Amityville, NY
• Providers in Amityville, NY by specialty
• Recreation Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.