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Organization
BRUCE R. GREENBAUM DPM PC
Active
Organization
BRUCE R. GREENBAUM DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE ROY GREENBAUM DPM (PRESIDENT)
(719) 265-2600
Entity
Organization
Contact information
Practice address
3000 OCEAN PKWY, SUITE 2G, BROOKLYN, NY 11235-8367
(718) 265-2600
(718) 265-0345
Mailing address
3000 OCEAN PKWY, SUITE 2G, BROOKLYN, NY 11235-8367
(718) 265-2600
(718) 265-0345
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N004557
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01190069
—
NY
01
—
WP8021
MEDICARE GRP
—
Enumeration date
06/04/2006
Last updated
11/13/2007
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