1003892928 NPI number — DR. ODED GREENBERG M.D.

Table of content: DR. ODED GREENBERG M.D. (NPI 1003892928)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003892928 NPI number — DR. ODED GREENBERG M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GREENBERG
Provider First Name:
ODED
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003892928
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/29/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
506 6TH ST
Provider Second Line Business Mailing Address:
NEW YORK METHODIST HOSPITAL
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11215-3609
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-780-5870
Provider Business Mailing Address Fax Number:
718-780-7720

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
506 6TH STREET
Provider Second Line Business Practice Location Address:
NEW YORK METHODIST HOSPITAL.
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11215-3609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-780-5870
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/22/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  MD-53140 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 178096 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01774932 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00809051 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".