Healthcare Provider Details

I. General information

NPI: 1922020841
Provider Name (Legal Business Name): JACOB J GREENBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 02/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 LOCUST ST MERCY HOSPITAL OF PITTSBURGH
PITTSBURGH PA
15219
US

IV. Provider business mailing address

PO BOX 641683
PITTSBURGH PA
15264
US

V. Phone/Fax

Practice location:
  • Phone: 412-232-8111
  • Fax:
Mailing address:
  • Phone: 412-232-8111
  • Fax: 412-485-5250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD036356L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: