Provider Demographics
NPI:1023007556
Name:GREENSPAN, NEIL ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:ROBERT
Last Name:GREENSPAN
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 1:44 W RIVER ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-2609
Mailing Address - Country:US
Mailing Address - Phone:401-274-4800
Mailing Address - Fax:401-454-0410
Practice Address - Street 1:44 W RIVER ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-2609
Practice Address - Country:US
Practice Address - Phone:401-274-4800
Practice Address - Fax:401-454-0410
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI7758207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI110-0OtherBLUE SHIELD
RI1142OtherNEIGHBORHOOD HEALTH PLAN
RI303209OtherHARVARD PILGRIM
RI5725-5OtherBLUE CROSS
RI7000105Medicaid
RI406209OtherTUFTS
RI4185OtherBLUE CHIP
RI1142OtherNEIGHBORHOOD HEALTH PLAN
RI303209OtherHARVARD PILGRIM