Doctor Name: | MRS. REINA S GREENBAUM |
NPI Number: | 1275791964 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RPA-C |
License Number: | MP200259 |
Business Practice Address: | 422 Western Hwy Tappan, NY - 109831311 |
Business Phone Number: | 8453590010 |
Business Fax Number: | |
Mailing Address: | 422 Western Hwy, TAPPAN |
State: | NY |
Postal Code: | 109831311 |
Phone Number: | 8453590010 |
Fax Number: | |
NPI Enumeration Date: | 05/29/2008 |
NPI Last Update Date: | 05/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | MP200259 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |