MEDICARE: DR. JEFFREY CRAIG GREENBERG PH.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	103T00000X	Psychologist	SI01913	NJ

General Provider Information

NPI Number	:	1386687796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY CRAIG GREENBERG PH.D.

Provider Business Mailing Address
First Line	:	340 E NORTHFIELD RD
Second Line	:	SUITE 1E
City	:	LIVINGSTON
State	:	NJ
Zip	:	07039-4892
Country	:	US
Telephone Number	:	973-533-9049
Fax Number	:	973-994-4737

Provider Business Practice Location Address
First Line	:	340 E NORTHFIELD RD
Second Line	:	SUITE 1E
City	:	LIVINGSTON
State	:	NJ
Zip	:	07039-4892
Country	:	US
Telephone Number	:	973-533-9049
Fax Number	:	973-994-4737

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

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	07/08/2007

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