Healthcare Provider Details

I. General information

NPI: 1346763109
Provider Name (Legal Business Name): JOSEPHINE GREENBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2017
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CAPITAL WAY
PENNINGTON NJ
08534-2520
US

IV. Provider business mailing address

24 FORREST BLEND DR
TITUSVILLE NJ
08560-1315
US

V. Phone/Fax

Practice location:
  • Phone: 800-637-2374
  • Fax:
Mailing address:
  • Phone: 215-380-1243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number26NJ14961200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN2314310
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN617916
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: