Provider Demographics
NPI:1306816491
Name:GREENBERG, WILLIAM JOEL (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOEL
Last Name:GREENBERG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:140 BUCK HILL DR
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18966-2805
Mailing Address - Country:US
Mailing Address - Phone:215-968-6800
Mailing Address - Fax:215-968-9091
Practice Address - Street 1:1 ROUTE 70
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5895
Practice Address - Country:US
Practice Address - Phone:732-905-5600
Practice Address - Fax:732-905-0611
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3760152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
T92049Medicare UPIN
NJ0000577980Medicare ID - Type Unspecified