Provider Demographics
NPI:1174612352
Name:GREENE, ELAINE Y (CNM)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:Y
Last Name:GREENE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 UNION DEPOSIT ROAD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111
Mailing Address - Country:US
Mailing Address - Phone:717-652-6605
Mailing Address - Fax:717-920-1265
Practice Address - Street 1:4700 UNION DEPOSIT ROAD
Practice Address - Street 2:SUITE 140
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111
Practice Address - Country:US
Practice Address - Phone:717-652-6605
Practice Address - Fax:717-920-1265
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW010138176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife