MEDICARE: JONATHAN GREENBERG DC

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	111NS0005X	Sports Physician Chiropractor	38MC00589700	NJ
2	111N00000X	Chiropractor	38MC00589700	NJ

General Provider Information

NPI Number	:	1386615482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN GREENBERG DC

Provider Business Mailing Address
First Line	:	175 W COHAWKIN RD STE C
Second Line	:
City	:	CLARKSBORO
State	:	NJ
Zip	:	08020-1145
Country	:	US
Telephone Number	:	609-823-9300
Fax Number	:	609-823-9505

Provider Business Practice Location Address
First Line	:	501 TILTON RD
Second Line	:
City	:	EGG HARBOR CITY
State	:	NJ
Zip	:	08215-5125
Country	:	US
Telephone Number	:	609-823-9300
Fax Number	:	609-823-9505

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

Provider Enumeration Date	:	01/28/2006
Last Update Date	:	10/30/2017

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Directions to “ JONATHAN GREENBERG DC” Practice Location

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