Individual
GARY GREENWALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2800 MARCUS AVE, NEW HYDE PARK, NY 11042-1113
(516) 622-6000
Mailing address
PO BOX 826223, PHILADELPHIA, PA 19182-6223
(866) 898-7142
(770) 237-1723
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
154918-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01008259
—
NY
01
—
773V41
BLUECROSS BLUESHIELD
NY
Enumeration date
12/29/2005
Last updated
02/19/2015
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