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NPI Code Detail

MEDICARE: DR. MAURY J GREENBERG M.D.

MEDICARE:  DR. MAURY J GREENBERG  M.D.
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
1207Q00000XFamily Medicine Physician154568NY
2207Q00000XFamily Medicine PhysicianME80844FL
3207Q00000XFamily Medicine PhysicianVT

General Provider Information

NPI Number : 1467451120
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAURY J GREENBERG M.D.
Provider Business Mailing Address
First Line : 2500 NESCONSET HWY
Second Line : BLDG 6D
City : STONY BROOK
State : NY
Zip : 11790-2555
Country : US
Telephone Number : 631-751-5550
Fax Number :
Provider Business Practice Location Address
First Line : 2500 NESCONSET HWY
Second Line : BLDG 6D
City : STONY BROOK
State : NY
Zip : 11790-2555
Country : US
Telephone Number : 631-751-5550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2005
Last Update Date : 07/08/2007

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Directions to “ DR. MAURY J GREENBERG M.D.” Practice Location

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