MEDICARE: MICHAEL L GREENBERG MD

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	207R00000X	Internal Medicine Physician	214334	NY
2	207P00000X	Emergency Medicine Physician	214334	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265479976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL L GREENBERG MD

Provider Business Mailing Address
First Line	:	11115 QUEENS BLVD
Second Line	:	FL 2
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-7479
Country	:	US
Telephone Number	:	718-544-6448
Fax Number	:	718-544-7719

Provider Business Practice Location Address
First Line	:	11115 QUEENS BLVD
Second Line	:	FL 2
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-7479
Country	:	US
Telephone Number	:	718-544-6448
Fax Number	:	718-544-7719

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

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	02/08/2017

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Directions to “ MICHAEL L GREENBERG MD” Practice Location

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