Healthcare Provider Details

I. General information

NPI: 1902123458
Provider Name (Legal Business Name): YONATAN YOSEF GREENSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 07/21/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 BERGEN ST RM I-354
NEWARK NJ
07103-2496
US

IV. Provider business mailing address

150 BERGEN ST RM I-354
NEWARK NJ
07103-2496
US

V. Phone/Fax

Practice location:
  • Phone: 973-972-6111
  • Fax: 888-950-7753
Mailing address:
  • Phone: 973-972-6111
  • Fax: 888-950-7753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number25MA10118900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number25MA10118900
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number25MA10118900
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA10118900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: