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Individual

DANA B GREENBLATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4623 SPRUCE ST, PHILADELPHIA, PA 19139-4542
(215) 474-6100
Mailing address
4623 SPRUCE ST, PHILADELPHIA, PA 19139-4542

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD045928L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0014219290001
PA
Enumeration date
06/22/2006
Last updated
02/18/2011
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