Provider Demographics
NPI:1154646396
Name:GREENBAUM, RONALD WALTER (RPH)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:WALTER
Last Name:GREENBAUM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 TREETOP CRES
Mailing Address - Street 2:THE ARBORS
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573-1644
Mailing Address - Country:US
Mailing Address - Phone:914-934-9176
Mailing Address - Fax:
Practice Address - Street 1:95 GRASSLANDS RD, ROOM LLE-01
Practice Address - Street 2:WESTCHESTER MEDICAL CENTER - MAIN PHARMACY
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595
Practice Address - Country:US
Practice Address - Phone:914-493-7207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032501183500000X
NJ28RI03062400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist