Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 0104555962 | VA |
N | 111NS0005X | Chiropractic Sports Physician | 03284 | MD |
NPI | 1154392694 |
---|---|
Provider Name | Jay S Greenstein |
First Address | Ft Washington, MD 20744-5145 |
Second Address | Rockville, MD 20858 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 08/07/2007 |