Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | N3092 | NY |
NPI | 1548252935 |
---|---|
Provider Name | Dr. Alan Jeffrey Greenberg |
First Address | Floral Park, NY 11001-4020 |
Second Address | Dix Hills, NY 11746-8335 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2005 |
Last Update Date | 02/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T31811 | (02) | NY |