Healthcare Provider Details

I. General information

NPI: 1396723094
Provider Name (Legal Business Name): SUSAN GREENBERG YARMUSH CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUSAN LYNN GREENBERG

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 MADISON ST MEDICAL STAFF OFFICE, ROOM 1249
NEW YORK NY
10002-7537
US

IV. Provider business mailing address

280 RIVERSIDE DR APT. GB
NEW YORK NY
10025-9010
US

V. Phone/Fax

Practice location:
  • Phone: 212-238-7680
  • Fax:
Mailing address:
  • Phone: 845-596-9110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number001166
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: