MEDICARE: DR. JOSHUA M GREENE 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	207W00000X	Ophthalmology Physician	MD428569	PA
2	207WX0107X	Retina Specialist (Ophthalmology) Physician	MD428569	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1245881	OTHER	PA	AETNA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2690993000	OTHER	PA	KEYSTONE HEALTH PLAN EAST
4	GR1835374	OTHER	PA	HIGHMARK

General Provider Information

NPI Number	:	1619978756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHUA M GREENE MD

Provider Business Mailing Address
First Line	:	2701 HOLME AVE STE 303
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-2029
Country	:	US
Telephone Number	:	215-335-3088
Fax Number	:	215-335-0315

Provider Business Practice Location Address
First Line	:	2701 HOLME AVE STE 303
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-2029
Country	:	US
Telephone Number	:	215-335-3088
Fax Number	:	215-335-0315

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	02/27/2019

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Directions to “ DR. JOSHUA M GREENE MD” Practice Location

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