Organization
GREENWICH STREET MEDICAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK BRUDER M.D. (PRESIDENT)
(914) 582-0749
Entity
Organization
Contact information
Practice address
315 MADISON AVE, NEW YORK, NY 10017-5405
(914) 582-0479
Mailing address
PO BOX 284H, SCARSDALE, NY 10583-8784
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
10/19/2012
Last updated
10/19/2012
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