Individual
BOB GREENWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1915
(551) 996-2200
(201) 489-2812
Mailing address
130 KINDERKAMACK RD STE 200, RIVER EDGE, NJ 07661-1931
(201) 488-2660
(201) 489-2812
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25MA04903900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0253707
—
NJ
Enumeration date
05/24/2006
Last updated
02/01/2017
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