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Individual

DR. ROBERT S GREENBAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1110 ROUTE 55 STE 105, LAGRANGEVILLE, NY 12540-5048
(845) 473-0220
(845) 473-0140
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
004414
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0007187044
AETNA
NY
05
02144998
NY
01
10032470
CDPHP
NY
01
597014
MVP HEALTH PLAN
NY
01
P2790040
OXFORD HEALTH INSURANCE
Enumeration date
06/22/2005
Last updated
12/13/2024
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