Healthcare Provider Details

I. General information

NPI: 1821484999
Provider Name (Legal Business Name): STEPHEN T. GREENBERG MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2015
Last Update Date: 04/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 CROSSWAYS PARK DR
WOODBURY NY
11797-2028
US

IV. Provider business mailing address

160 CROSSWAYS PARK DR
WOODBURY NY
11797-2028
US

V. Phone/Fax

Practice location:
  • Phone: 516-364-4200
  • Fax: 516-364-6562
Mailing address:
  • Phone: 516-364-4200
  • Fax: 516-364-6562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN TODD GREENBERG
Title or Position: OWNER
Credential: MD
Phone: 516-354-4200