Healthcare Provider Details

I. General information

NPI: 1063457018
Provider Name (Legal Business Name): ERIC JAY GREENBERG RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7305 N MILITARY TRL
RIVIERA BEACH FL
33410-7417
US

IV. Provider business mailing address

115 ROSEWOOD CIR
JUPITER FL
33458-5540
US

V. Phone/Fax

Practice location:
  • Phone: 561-422-6383
  • Fax:
Mailing address:
  • Phone: 561-745-6753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN3096202
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: