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Individual

STEPHEN ROBERT GREENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
233 UNION AVENUE, SUITE 104/105, HOLBROOK, NY 11741-1820
(631) 285-7311
Mailing address
260 E MIDDLE COUNTRY RD, SUITE 201, SMITHTOWN, NY 11787-2982
(631) 265-8780
(631) 265-8521

Taxonomy

Speciality
Code
Description
License number
State
156FX1100X
Ophthalmic Technician/Technologist
106798
NY
207W00000X
Ophthalmology Physician
Primary
106798
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00187595
NY
Enumeration date
09/06/2006
Last updated
02/09/2015
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