Individual
JACK GREENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 E 40TH ST RM 607, NEW YORK, NY 10016-1201
(212) 689-1331
(212) 685-1452
Mailing address
7139 166TH ST, FLUSHING, NY 11365-3235
(718) 380-1173
(212) 685-1452
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
142512
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00829745
—
NY
Enumeration date
07/14/2005
Last updated
08/01/2008
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