Healthcare Provider Details

I. General information

NPI: 1215908413
Provider Name (Legal Business Name): ALFRED D GREISMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 12/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1270 HIGHWAY 35
MIDDLETOWN NJ
07748-2014
US

IV. Provider business mailing address

PO BOX 8000 DEPT 596
BUFFALO NY
14267-0002
US

V. Phone/Fax

Practice location:
  • Phone: 732-615-3900
  • Fax: 732-615-0865
Mailing address:
  • Phone: 732-615-3900
  • Fax: 732-615-0865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMA20221
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: