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General NPI Number Information
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NPI Number | 1972653384
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Entity Type | Individual
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Provider Name | SCOTT R GREENBERG MD
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Gender | Male
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 06/26/2020
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Provider Practice Location Address
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Address Line | 101 S. BRYN MAWR AVE 300A
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City | BRYN MAWR
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State | PA
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Zip | 19010-3124
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Country | US
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Telephone | 833-440-4325
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Fax | 484-380-2115
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Provider Business Mailing Address
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Address Line | 101 S. BRYN MAWR AVE 300A
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City | BRYN MAWR
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State | PA
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Zip | 19010-3124
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Country | US
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Telephone | 833-440-4325
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Fax | 484-380-2115
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MA69121
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD065771L
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License Number State | PA
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