Provider Demographics
NPI:1093364549
Name:GREENBERG, MARGIE ANNE (RD)
Entity Type:Individual
Prefix:MRS
First Name:MARGIE
Middle Name:ANNE
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 N BRIDGE TER
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3830
Mailing Address - Country:US
Mailing Address - Phone:914-649-5030
Mailing Address - Fax:
Practice Address - Street 1:1 N BRIDGE TER
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3830
Practice Address - Country:US
Practice Address - Phone:914-649-5030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-07
Last Update Date:2019-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL720811133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered