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General NPI Number Information
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NPI Number | 1477675742
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Entity Type | Individual
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Provider Name | LAWRENCE GREENBERG M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/05/2007
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Last Update Date | 01/10/2019
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Provider Practice Location Address
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Address Line | 291 IRONWOOD CIR
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City | ELKINS PARK
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State | PA
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Zip | 19027-1317
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Country | US
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Telephone | 215-885-8265
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Fax | 215-885-5672
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Provider Business Mailing Address
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Address Line | 291 IRONWOOD CIR
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City | ELKINS PARK
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State | PA
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Zip | 19027-1317
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Country | US
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Telephone | 215-885-8265
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Fax | 215-885-5672
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD430986
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License Number State | PA
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