1326148008 NPI number — WILLA M GREENBERG DO

Table of content: WILLA M GREENBERG DO (NPI 1326148008)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326148008 NPI number — WILLA M GREENBERG DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GREENBERG
Provider First Name:
WILLA
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

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:
1326148008
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/12/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 COOPER PLZ
Provider Second Line Business Mailing Address:
THE COOPER HOSPITALIST TEAM
Provider Business Mailing Address City Name:
CAMDEN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08103-1461
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-342-3150
Provider Business Mailing Address Fax Number:
856-968-8418

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 COOPER PLZ
Provider Second Line Business Practice Location Address:
THE COOPER HOSPITALIST TEAM
Provider Business Practice Location Address City Name:
CAMDEN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08103-1461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-342-3150
Provider Business Practice Location Address Fax Number:
856-968-8418
Provider Enumeration Date:
09/23/2006

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: 208100000X , with the licence number:  MB55787 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 260022261 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0692956000 . This is a "AMERIHEALTH HMO, KEYSTONE, IBC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6115306 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010003827 . This is a "AMERICHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 751132 . This is a "AMERIHEALTH PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3300778 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 32410 . This is a "UNIVERSITY HEALTHPLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 463535 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1061117 . This is a "HORIZON NJ HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1993657 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3K6028 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: P561485 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".




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