Provider Demographics
NPI:1689608812
Name:STIEBEL-CHIN, GRETA (MD)
Entity type:Individual
Prefix:
First Name:GRETA
Middle Name:
Last Name:STIEBEL-CHIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 45TH ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2450
Mailing Address - Country:US
Mailing Address - Phone:561-848-8701
Mailing Address - Fax:561-848-9059
Practice Address - Street 1:927 45TH ST
Practice Address - Street 2:SUITE 205
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2450
Practice Address - Country:US
Practice Address - Phone:561-848-8701
Practice Address - Fax:561-848-9059
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME44971208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE82200Medicare UPIN