Provider Demographics
NPI:1053670125
Name:GREENBERG, BEVERLY CYPEN (DO)
Entity Type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:CYPEN
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2690 HACKNEY RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3003
Mailing Address - Country:US
Mailing Address - Phone:954-384-1852
Mailing Address - Fax:954-384-6130
Practice Address - Street 1:2690 HACKNEY RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3003
Practice Address - Country:US
Practice Address - Phone:954-384-1852
Practice Address - Fax:954-384-6130
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-10
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL36972207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine