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NPI Code Detail

MEDICARE: DR. GREGG DAVID BLUMBERG DO

MEDICARE: DR. GREGG DAVID BLUMBERG DO
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
12085R0202XDiagnostic Radiology Physician1659994440NJ

General Provider Information

NPI Number : 1659994440
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGG DAVID BLUMBERG DO
Provider Business Mailing Address
First Line : 355 GRAND ST
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07302-4321
Country : US
Telephone Number : 201-915-2000
Fax Number :
Provider Business Practice Location Address
First Line : NYU LISOM 222 STATION PLAZA NORTH
Second Line : SUITE 510
City : MINEOLA
State : NY
Zip : 11501-3893
Country : US
Telephone Number : 516-663-8794
Fax Number : 516-663-8796
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2020
Last Update Date : 04/13/2026

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Directions to “ DR. GREGG DAVID BLUMBERG DO” Practice Location

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