Provider Demographics
NPI:1437206554
Name:GREENBERG, JUDITH J (MD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:J
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE ATWELL RD.
Mailing Address - Street 2:BASSETT MEDICAL CENTER, PSYCHIATRY OPD
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326
Mailing Address - Country:US
Mailing Address - Phone:607-547-3500
Mailing Address - Fax:607-547-6550
Practice Address - Street 1:ONE ATWELL RD.
Practice Address - Street 2:BASSETT MEDICAL CENTER, PSYCHIATRY OPD
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326
Practice Address - Country:US
Practice Address - Phone:607-547-3500
Practice Address - Fax:607-547-6550
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1582792084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A60437Medicare UPIN