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General NPI Number Information
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NPI Number | 1073764809
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Entity Type | Individual
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Provider Name | WILLIAM JAY GREENBERG M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/10/2008
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Last Update Date | 05/24/2022
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Provider Practice Location Address
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Address Line | 455 CENTRAL PARK AVE
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City | SCARSDALE
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State | NY
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Zip | 10583-1060
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Country | US
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Telephone | 914-819-0409
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Fax |
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Provider Business Mailing Address
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Address Line | 238 E 77TH ST APT LL
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City | NEW YORK
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State | NY
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Zip | 10075-2157
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Country | US
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Telephone | 212-253-7138
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | 175281-1
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License Number State | NY
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