MEDICARE: DR. DAVID SAMUEL GREENSTEIN O.D. , M. S.

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	152W00000X	Optometrist	2817	MA

General Provider Information

NPI Number	:	1376518332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID SAMUEL GREENSTEIN O.D. , M. S.

Provider Business Mailing Address
First Line	:	81 COREY ST
Second Line	:
City	:	WEST ROXBURY
State	:	MA
Zip	:	02132-2338
Country	:	US
Telephone Number	:	617-323-3338
Fax Number	:	617-323-3338

Provider Business Practice Location Address
First Line	:	81 COREY ST
Second Line	:
City	:	WEST ROXBURY
State	:	MA
Zip	:	02132-2338
Country	:	US
Telephone Number	:	617-323-3338
Fax Number	:	617-323-3338

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

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	07/08/2007

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