Healthcare Provider Details

I. General information

NPI: 1215586771
Provider Name (Legal Business Name): SARA GREENBERG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2019
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 BEACH 20TH ST UNIT 1R
FAR ROCKAWAY NY
11691-3900
US

IV. Provider business mailing address

1710 NEW HAVEN AVE
FAR ROCKAWAY NY
11691-5115
US

V. Phone/Fax

Practice location:
  • Phone: 347-619-8880
  • Fax:
Mailing address:
  • Phone: 516-330-2382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number065656
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: