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General NPI Number Information
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NPI Number | 1235111493
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Entity Type | Individual
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Provider Name | GARY DAVID GREENSTEIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 101 PROSPECT ST SUITE 202
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5020
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Country | US
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Telephone | 732-942-4442
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Fax |
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Provider Business Mailing Address
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Address Line | 35 STONY HILL DR
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City | MORGANVILLE
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State | NJ
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Zip | 07751-1176
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Country | US
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Telephone | 732-851-5973
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 79483
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 208875
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License Number State | NY
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