MEDICARE: DR. WILLIAM MICHAEL GREENBERG M.D.

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	2084P0800X	Psychiatry Physician	138490-1	NY
2	2084P0800X	Psychiatry Physician	25MA05202700	NJ

General Provider Information

NPI Number	:	1316047889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM MICHAEL GREENBERG M.D.

Provider Business Mailing Address
First Line	:	65 NORTH MAPLE AVENUE
Second Line	:
City	:	RIDGEWOOD
State	:	NJ
Zip	:	07450-3233
Country	:	US
Telephone Number	:	201-689-1001
Fax Number	:	845-262-1242

Provider Business Practice Location Address
First Line	:	65 NORTH MAPLE AVENUE
Second Line	:
City	:	RIDGEWOOD
State	:	NJ
Zip	:	07450-3233
Country	:	US
Telephone Number	:	201-689-1001
Fax Number	:	845-262-1242

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	04/27/2023

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Directions to “ DR. WILLIAM MICHAEL GREENBERG M.D.” Practice Location

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