MEDICARE: JOHN THOMAS GREENFIELD MD

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	208D00000X	General Practice Physician	P124990	NY

General Provider Information

NPI Number	:	1730960451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN THOMAS GREENFIELD MD

Provider Business Mailing Address
First Line	:	2626 HALPERIN AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-2631
Country	:	US
Telephone Number	:	718-618-0401
Fax Number	:	347-479-1303

Provider Business Practice Location Address
First Line	:	700 WHITE PLAINS RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10473-2634
Country	:	US
Telephone Number	:	718-583-7736
Fax Number	:	718-537-6180

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

Provider Enumeration Date	:	10/09/2023
Last Update Date	:	10/09/2023

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