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General NPI Number Information
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NPI Number | 1518285063
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Entity Type | Organization
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Legal Business Name | LAWRENCE B GREENBERG MD PC
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Dates
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Enumeration Date | 05/07/2010
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Last Update Date | 01/31/2011
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Provider Practice Location Address
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Address Line | 330 MOTOR PKWY SUITE 204
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City | HAUPPAUGE
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State | NY
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Zip | 11788-5104
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Country | US
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Telephone | 631-617-6903
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Fax | 631-617-6902
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Provider Business Mailing Address
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Address Line | 330 MOTOR PKWY SUITE 204
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City | HAUPPAUGE
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State | NY
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Zip | 11788-5104
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Country | US
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Telephone | 631-617-6903
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Fax | 631-617-6902
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Authorized Official
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Title or Position | PRESIDENT
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Name | LAWRENCE B GREENBERG
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Credential | MD
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Telephone | 631-617-6903
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 154567-1
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License Number State | NY
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