Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N004559 | NY |
NPI | 1134123110 |
---|---|
Provider Name | Dr. Paul Michael Greenberg |
First Address | New York, NY 10024-6474 |
Second Address | New York, NY 10024-6474 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2005 |
Last Update Date | 06/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01258662 | (05) | NY |
U27611 | (02) |