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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