Provider Demographics
NPI:1003892928
Name:GREENBERG, ODED (MD)
Entity Type:Individual
Prefix:DR
First Name:ODED
Middle Name:
Last Name:GREENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 6TH ST
Mailing Address - Street 2:NEW YORK METHODIST HOSPITAL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3609
Mailing Address - Country:US
Mailing Address - Phone:718-780-5870
Mailing Address - Fax:718-780-7720
Practice Address - Street 1:506 6TH STREET
Practice Address - Street 2:NEW YORK METHODIST HOSPITAL.
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3609
Practice Address - Country:US
Practice Address - Phone:718-780-5870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1780962085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01774932Medicaid
NYP00809051OtherRAILROAD MEDICARE
NYP00809051OtherRAILROAD MEDICARE
NY01774932Medicaid
NYA400012301Medicare PIN