Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 022559 | CT |
N | 208200000X | Surgeon | 022559 | CT |
N | 208600000X | Surgeon | 022559 | CT |
NPI | 1124115662 |
---|---|
Provider Name | Dr. Sheldon Burt Greenberg |
First Address | Norwalk, CT 06851-1080 |
Second Address | Norwalk, CT 06851-1080 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 15/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00125598 | (05) | CT |
D02631 | (02) | CT |