MEDICARE: MS. RONNIE S GREENBERG MSW LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	44SC00584000	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	P2866502	OTHER	OXFORD
2	CA000197	OTHER	ST BARNABUS HEALTH SYSTEM
3	186000	OTHER	MHN
4	232073	OTHER	COMPSYCH
5	UBH3088929228	OTHER	VALUE
6	460341A783714	OTHER	OPTIONS
7	7334601	OTHER	GHI
8	9394585	OTHER	PHC

General Provider Information

NPI Number	:	1053413096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RONNIE S GREENBERG MSW LCSW

Provider Business Mailing Address
First Line	:	747 LIVINGSTON RD
Second Line	:
City	:	ELIZABETH
State	:	NJ
Zip	:	07208-1352
Country	:	US
Telephone Number	:	908-838-0195
Fax Number	:

Provider Business Practice Location Address
First Line	:	747 LIVINGSTON RD
Second Line	:
City	:	ELIZABETH
State	:	NJ
Zip	:	07208-1352
Country	:	US
Telephone Number	:	908-838-0195
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	02/26/2008

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