MEDICARE: ANTJE L GREENFIELD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	25MA08024800	NJ
2	2085R0202X	Diagnostic Radiology Physician	MD072659L	PA

General Provider Information

NPI Number	:	1154398816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTJE L GREENFIELD MD

Provider Business Mailing Address
First Line	:	1865 ROUTE 70 EAST
Second Line	:	SUITE 130
City	:	CHERRY HILL
State	:	NJ
Zip	:	08003-2013
Country	:	US
Telephone Number	:	856-433-2535
Fax Number	:	856-528-5221

Provider Business Practice Location Address
First Line	:	1001 CHESTERBROOK BLVD
Second Line	:
City	:	BERWYN
State	:	PA
Zip	:	19312-3805
Country	:	US
Telephone Number	:	610-576-7500
Fax Number	:	610-576-7551

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2006
Last Update Date	:	10/28/2022

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