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Individual

MR. BRUCE GREENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
24202 61ST AVE, DOUGLASTON, NY 11362-1996
(718) 423-6734
Mailing address
24015 67TH AVE, DOUGLASTON, NY 11362-1926
(718) 631-4612

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
035160
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
035160
STATE LISCENCE NUMBER
NY
Enumeration date
02/15/2008
Last updated
02/15/2008
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