Healthcare Provider Details

I. General information

NPI: 1013962257
Provider Name (Legal Business Name): ELIZABETH A GREENFIELD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 10/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125-06 101ST AVENUE
RICHMOND HILLS NY
11581
US

IV. Provider business mailing address

1000 ZECKENDORF BLVD
GARDEN CITY NY
11530-2133
US

V. Phone/Fax

Practice location:
  • Phone: 718-849-2900
  • Fax: 718-943-2631
Mailing address:
  • Phone: 516-542-6880
  • Fax: 516-542-5556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number159477
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: