Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 3760 | NJ |
NPI | 1306816491 |
---|---|
Provider Name | Dr. William Joel Greenberg |
First Address | Holland, PA 18966-2805 |
Second Address | Lakewood, NJ 08701-5895 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T92049 | (02) |