Healthcare Provider Details

I. General information

NPI: 1538246228
Provider Name (Legal Business Name): JUDITH GREENBERG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 S. ADAMS RD SUITE 188
BIRMINGHAM MI
48000
US

IV. Provider business mailing address

P.O. BOX 1568
BIRMINGHAM MI
48012-1568
US

V. Phone/Fax

Practice location:
  • Phone: 248-594-9500
  • Fax: 248-594-9599
Mailing address:
  • Phone: 248-594-9500
  • Fax: 248-594-9599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number16010000067
License Number StateMI

VIII. Authorized Official

Name: JUDITH GREENBERG
Title or Position: PRESIDENT
Credential:
Phone: 248-594-9500