Healthcare Provider Details

I. General information

NPI: 1477689412
Provider Name (Legal Business Name): LORIE E GREENBERG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 N MIDLAND AVE NYACK HOSPITAL
NYACK NY
10960-1912
US

IV. Provider business mailing address

651 W MOUNT PLEASANT AVE HOSPITALIST EMO OF NY, PC
LIVINGSTON NJ
07039-1600
US

V. Phone/Fax

Practice location:
  • Phone: 845-348-2000
  • Fax:
Mailing address:
  • Phone: 973-251-1177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number242596-1
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: