Healthcare Provider Details

I. General information

NPI: 1427057975
Provider Name (Legal Business Name): PAUL A.C. GREENBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: PAUL ALAN CECIL GREENBERG MD

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15811 HARRY VAN ARSDALE JR AVE
FLUSHING NY
11365-3085
US

IV. Provider business mailing address

15811 HARRY VAN ARSDALE JR AVE
FLUSHING NY
11365-3085
US

V. Phone/Fax

Practice location:
  • Phone: 718-591-2014
  • Fax: 718-591-9528
Mailing address:
  • Phone: 718-591-2014
  • Fax: 718-591-9528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number165801
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: