Provider Demographics
NPI:1508692583
Name:MOC, GRETA
Entity type:Individual
Prefix:
First Name:GRETA
Middle Name:
Last Name:MOC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8050 NW 103RD ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2252
Mailing Address - Country:US
Mailing Address - Phone:786-350-2313
Mailing Address - Fax:305-520-0318
Practice Address - Street 1:8050 NW 103RD ST
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33016-2252
Practice Address - Country:US
Practice Address - Phone:786-350-2313
Practice Address - Fax:305-520-0318
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care