Provider Demographics
NPI:1326148008
Name:GREENBERG, WILLA M (DO)
Entity Type:Individual
Prefix:
First Name:WILLA
Middle Name:M
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 COOPER PLZ
Mailing Address - Street 2:THE COOPER HOSPITALIST TEAM
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1461
Mailing Address - Country:US
Mailing Address - Phone:856-342-3150
Mailing Address - Fax:856-968-8418
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:THE COOPER HOSPITALIST TEAM
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-3150
Practice Address - Fax:856-968-8418
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMB55787208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
260022261OtherRR MEDICARE
0692956000OtherAMERIHEALTH HMO, KEYSTONE, IBC
NJ6115306Medicaid
010003827OtherAMERICHOICE
751132OtherAMERIHEALTH PPO
3300778OtherCIGNA
32410OtherUNIVERSITY HEALTHPLAN
463535OtherAETNA
1061117OtherHORIZON NJ HEALTH
1993657OtherUNITED HEALTHCARE
3K6028OtherHEALTHNET
P561485OtherOXFORD
751132OtherAMERIHEALTH PPO
NJ751132Medicare PIN