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General NPI Number Information
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NPI Number | 1154438521
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Entity Type | Organization
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Legal Business Name | MARVIN H. GREENBAUM, M.D. PC
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 501 BELMONT AVE
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1302
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Country | US
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Telephone | 610-667-4066
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Fax | 610-667-7955
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Provider Business Mailing Address
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Address Line | 501 BELMONT AVE
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1302
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Country | US
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Telephone | 610-667-4066
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Fax | 610-667-7955
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Authorized Official
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Title or Position | OPHTHALMOLOGY
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Name | DR. KEITH J MATHERS
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Credential | M.D.
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Telephone | 610-667-4066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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