1275659997 NPI number — ROBERT N. GREENBERG, MD

Table of content: (NPI 1275659997)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275659997 NPI number — ROBERT N. GREENBERG, MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBERT N. GREENBERG, MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1275659997
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2211 QUARRY DR
Provider Second Line Business Mailing Address:
SUITE E-61
Provider Business Mailing Address City Name:
READING
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19609-1161
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-670-4959
Provider Business Mailing Address Fax Number:
610-670-5150

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2211 QUARRY DR
Provider Second Line Business Practice Location Address:
SUITE E-61
Provider Business Practice Location Address City Name:
READING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19609-1161
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-670-4959
Provider Business Practice Location Address Fax Number:
610-670-5150
Provider Enumeration Date:
03/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GREENBERG
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
N
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
610-670-4959

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  MD-025027-E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 02359200 . This is a "KHPC AND KSB" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1002821 . This is a "MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 00020823 . This is a "IBC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0790430000 . This is a "KHPE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 020823 . This is a "BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 02359200 . This is a "CAP BC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 123339 . This is a "HEALTH AMERICA HLTH ASSUR" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 39691 . This is a "GEISINGER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 116220 . This is a "UNISON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2318194 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0009648670002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7049177 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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