Healthcare Provider Details

I. General information

NPI: 1124419387
Provider Name (Legal Business Name): SCOTT M. GREENFIELD, D.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2015
Last Update Date: 02/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1931 RICHMOND AVE
STATEN ISLAND NY
10314-3889
US

IV. Provider business mailing address

1931 RICHMOND AVE
STATEN ISLAND NY
10314-3889
US

V. Phone/Fax

Practice location:
  • Phone: 718-477-9301
  • Fax: 718-477-9301
Mailing address:
  • Phone: 718-477-9301
  • Fax: 718-477-9301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberXOO7372
License Number StateNY

VIII. Authorized Official

Name: DR. SCOTT M GREENFIELD
Title or Position: OWNER/OPERATOR
Credential: D.C.
Phone: 646-256-1453