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General NPI Number Information
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NPI Number | 1295704278
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Entity Type | Individual
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Provider Name | GWEN STEPHANIE GREENBERG D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 11/06/2013
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Provider Practice Location Address
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Address Line | 1255 S CEDAR CREST BLVD SUITE 2900
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City | ALLENTOWN
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State | PA
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Zip | 18103-6256
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Country | US
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Telephone | 610-437-3939
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Fax | 484-244-2862
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Provider Business Mailing Address
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Address Line | 1405 N CEDAR CREST BLVD SUITE 115
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City | ALLENTOWN
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State | PA
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Zip | 18104-2308
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Country | US
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Telephone | 610-437-3939
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Fax | 484-244-2862
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC001792L
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License Number State | PA
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