| Sunrise Psychology, Pllc | |
|
363 Route 111 Ste 102 Smithtown NY 11787-4750 | |
| (631) 780-6804 | |
| (631) 780-6806 |
| Full Name | Sunrise Psychology, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 363 Route 111 Ste 102, Smithtown, New York |
| Authorized Official Name and Position | Eva Marie Greco (OWNER) |
| Authorized Official Contact | 3057247220 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Psychology, Pllc 26 2nd Ave East Islip NY 11730-2012 Ph: (305) 724-7220 | Sunrise Psychology, Pllc 363 Route 111 Ste 102 Smithtown NY 11787-4750 Ph: (631) 780-6804 |
| NPI Number | 1366796005 |
|---|---|
| Provider Enumeration Date | 11/02/2012 |
| Last Update Date | 11/02/2012 |
| Medicare PECOS PAC ID | 9032369798 |
|---|---|
| Medicare Enrollment ID | O20130624000005 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366796005 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 018315-1 (New York) | Primary |
| Provider Name | Eva M Greco |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134454143 PECOS PAC ID: 2062555675 Enrollment ID: I20100204000596 |
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