Healthcare Provider Details

I. General information

NPI: 1205931789
Provider Name (Legal Business Name): DAVID S GREENSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 10/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 CONANT ST 1ST FL
BEVERLY MA
01915-1665
US

IV. Provider business mailing address

280 MERRIMACK ST STE 311
LAWRENCE MA
01843-1779
US

V. Phone/Fax

Practice location:
  • Phone: 978-927-5254
  • Fax: 978-927-5174
Mailing address:
  • Phone: 978-691-5690
  • Fax: 978-691-5693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number81143
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: