Provider Demographics
NPI:1275870248
Name:JEFFREY GREENBERG,MD OBGYN , P.S.C.
Entity Type:Organization
Organization Name:JEFFREY GREENBERG,MD OBGYN , P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-565-8543
Mailing Address - Street 1:URB. VILLAS DEL SOL
Mailing Address - Street 2:CALLE TORREMOLINO # 401
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985-5108
Mailing Address - Country:US
Mailing Address - Phone:787-565-8543
Mailing Address - Fax:
Practice Address - Street 1:AVE LAGUNA
Practice Address - Street 2:LAGUNA GARDENS SHOPPING CENTER SUITE 203
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-6525
Practice Address - Country:US
Practice Address - Phone:787-234-3636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-11
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14357207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty