Provider Demographics
NPI:1245568146
Name:GREENBERG, JUSTINE E (RPA-C)
Entity Type:Individual
Prefix:
First Name:JUSTINE
Middle Name:E
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:RPA-C
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Mailing Address - Street 1:2090 DEER PARK AVE
Mailing Address - Street 2:FAMILY MEDICAL CARE OF BABYLON
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-2129
Mailing Address - Country:US
Mailing Address - Phone:631-667-9440
Mailing Address - Fax:631-667-3018
Practice Address - Street 1:2090 DEER PARK AVE
Practice Address - Street 2:FAMILY MEDICAL CARE OF BABYLON
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-2129
Practice Address - Country:US
Practice Address - Phone:631-667-9440
Practice Address - Fax:631-667-3018
Is Sole Proprietor?:No
Enumeration Date:2009-12-03
Last Update Date:2014-01-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY013371363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant