Provider Demographics
NPI:1073591558
Name:GREENBERGER, BRETT I (MD)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:I
Last Name:GREENBERGER
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 1:5750 PARK HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-3930
Mailing Address - Country:US
Mailing Address - Phone:410-843-7415
Mailing Address - Fax:410-500-5958
Practice Address - Street 1:5750 PARK HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-3930
Practice Address - Country:US
Practice Address - Phone:410-843-7415
Practice Address - Fax:410-500-5958
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDO0610722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
I 25863Medicare UPIN
MDH103M957Medicare PIN