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General NPI Number Information
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NPI Number | 1326160920
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Entity Type | Organization
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Legal Business Name | RONALD B. GREENE, MD P.C.
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 11/27/2007
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Provider Practice Location Address
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Address Line | 225 E CITY AVE SUITE105
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1704
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Country | US
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Telephone | 610-664-8828
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Fax | 610-664-8829
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Provider Business Mailing Address
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Address Line | 225 E CITY AVE SUITE105
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1704
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Country | US
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Telephone | 610-664-8828
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Fax | 610-664-8829
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RONALD BARRY GREENE
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Credential | M.D.
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Telephone | 610-664-8828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD014521E
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License Number State | PA
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